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

Specifically, why some scars sit nicely below the underwear line and others seem much higher.

Doctor Answers 8

How to decide where to put a tummy tuck scar

A tummy tuck scar is ideally placed low enough to be hidden by most typical low-rise jeans or bikinis.  It's quite easy to place a MINI-tummy tuck scar very low because only the loose skin below the belly button is removed.  When a FULL tummy tuck is done, though, the placement of the scar depends on how much loose skin you have around and above the belly button.  Think of it this way, we make a cut around the belly button, then pull the skin down on the abdomen and remove the excess.  We have to be able to remove the hole we just cut around the belly button, or you'll end up with an extra scar on your middle lower abdomen after the surgery.  If you need a full tummy-tuck, but don't have enough skin laxity for us to reach a low scar, then we have to place the scar higher.

By the way, I would advise you NOT to choose a mini-tummy tuck if what you need is a full tummy-tuck. Mini-proceures lead to mini-results, and you'll find quite a few posts from women who had mini-tummy tucks and now need to have a full tummy tuck to get the results they wanted from the start.

Atlanta Plastic Surgeon
4.5 out of 5 stars 42 reviews

Position of tummy tuck scars depends on skin excess

Unless you have a substantial amount of skin excess, the tummy tuck scar won't be as low as in those who do have enough excess skin to be able to push the scar lower.  It's all about your body and your starting point.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Tummy Tuck Scar Location?

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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Abdominal scar for tummy tuck

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..

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Tummy tuck scar

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.

Jason Hess, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

How low can you go? Tummy tuck incisions and scars

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. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Anchoring sutures

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.

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Tummy tuck scars should always be below the bikini line

When done properly tummy tuck scars will always end up below the top of a bikini bottom. Check out your plastic surgeon's photos carefully before you pick one.

Mark Broudo, MD
Miami Plastic Surgeon
4.5 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.