What Determines How Low on the Abdomen a Tummy Tuck Scar Is?

Ideally, a tummy tuck scar should fall below the bikini line.  In patients who have moderate to severe excess skin, there is little difficulty placing the scar in the suprapubic region.  Essentially, skin from the region above the navel is relocated to the lower abdomen.  If there is not an excess amount of skin, the incision can still be placed quite low, but there may be a short vertical extension of this incision.  If you are reviewing this forum, you probably already know what to look for in your plastic surgeon.  First of all, make sure that he or she is indeed a plastic surgeon.  Most states have a website that will allow you to find whether action or complaints have occurred against a physician's license.  Also, make sure they are board certified in plastic surgery.  When these credentials are valid, you are more likely to achieve the results you seek.  I have witnessed physicians in the community performing abdominoplasty who are otolaryngologists, gynecologists, and even emergency medicine doctors.  So, do your homework and check credentials.  This will not guarantee the results you seek, but it will certainly increase the odds of achieving them.  Part of the scar placement and overall outcome relates to preoperative planning by your physician.  Seek a doctor with patience.  This is critical in the operating room and in follow up.  Good luck.

Generally speaking the scar can be anywhere you want it but it is more commonly placed at the level where it will allow you to completely excise the belly button scar. If you place it too low, you will have a vertical 1 inch scar midway between your scar and the new belly button. 

Thank you for your post. It is not common for surgeons to anchor the lower incision to the fascia or covering of the abdominal muscles to keep the scar low, however, I do use this technique and agree with it. All the tension on the incision is from above, not below, and thus the scar tends to move toward the area of maximal tension (towards the ribs/bellybutton). This moves the scar higher than desired. I like to keep my scars very low, and feel that anchoring the scar helps accomplish this. The following photo is an example of this.

Thank you for the question.

The main determinant of the tummy tuck incision and resulting scar line is the patient's body type.  Ideally the incision and resulting skyline is kept as little as possible,  planned to be hidden beneath undergarments and swimming suit.

If the patient has a significant amount of redundant skin (especially about the umbilicus)  then the incision and resulting scar line  of the tummy tuck may be kept  very low. On the other hand, if the patient has a short torso and/or very little skin above the umbilicus then the  incision and scar line may need to be placed higher.  Sometimes a short vertical scar is also necessary (previous umbilical opening). 

I hope this helps.

I think that the location of the final incision is based upon two things.  The markings for the surgery and the tension that the closure is under after the uppr flap is pulled down to the lower incision..