Which tummy tuck technique would be best while avoiding a vertical scar? (photos)

thank you for posting your question. Based on your pictures, an extended lipoabdominoplasty with muscle tightening will give you a huge improvement. There might be some remaining loose skin, but there will be also no vertical scar. I hope this helps.

Hello, and thank you for your question about which tummy tuck technique would be best to avoid a vertical scar. Thank you for your history and your pictures. Congratulations on your weight loss. Regarding your abdomen, you have a distended abdomen, probably due to increased peritoneal fat and rectus diastasis. Rectus diastasis is the weakening of one of the ventral anterior abdominal muscles, namely the rectus abdominis. You have some excess skin and fat. Your best treatment would be an extended high lateral tension abdominoplasty, also known as a high lateral tension tummy tuck. An extended high lateral tension tummy tuck means an incision would be placed low in the pubic region and then continue high over the hips. Some patients called this form of tummy tuck a "handlebar tummy tuck" because of the shape of the scar. During the extended high lateral tension tummy tuck, dissection would be done to the belly button and then further dissection to the bottom of the sternum. This dissection would lead to full exposure of the entire abdominal wall. You do not need the vertical incision. Once your abdomen is isolated, the rectus abdominis muscle can be flattened. You can see the distention of the abdomen, especially on your profile view. This is due to the weakened rectus abdominis muscle as well as retromuscular or intraperitoneal fat. Intraperitoneal fat is also called visceral fat. After the correction of the rectus diastasis, your abdomen should be flat. For further anterior wall reinforcement, you may or may not need placement of abdominal wall mesh to add further support. Then, the skin from the top of the belly button is brought down to the pubic region. Essentially, all the skin from your C-section scar to the top of your belly button is eliminated. The skin of the abdomen is then reconnected, and the belly button is relocated. Therefore, you do not need a vertical incision or a fleur de lis incision. You need an extended high lateral tension tummy tuck. I hope I have answered your question regarding which tummy tuck technique would be best for avoiding a vertical scar.
If you have any more questions regarding the tummy tuck or abdominoplasty, please get in touch with an experienced plastic surgeon. Since an abdominoplasty can be a challenging procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing tummy tucks. Do your research. Make sure your chosen plastic surgeon has performed at least 100 abdominoplasties. Make sure they have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. Good luck! Sincerely, Dr. Katzen, MD, MBA (Aesthetic, Cosmetic and Reconstructive Plastic Surgeon), President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Thank you for your photos. I would agree that an extended tummy tuck with diastasis repair would be required to remove the horizontal laxity of your abdomen. Whether to include a vertical incision is entirely up to you. The vertical incision is used to tighten the upper and mid abdominal skin in patients with a large amount of skin laxity, and also helps to narrow the waistline. However, it is only an option, not a requirement. if you choose not to have the vertical incision, the trade-off is that your upper and mid abdominal skin may be slightly looser. You appear to have enough redundant breast skin and tissue that you may consider having your breast lift done first, allowing the lift to settle and achieve its final resting position prior to adding an implant. Performing a breast augmentation and a breast lift at the same time has a higher incidence of requiring a revisional surgery as the breast tissue relaxes and slides off the implant. Speak with your plastic surgeon about these options and which one would be safest for you.

Thanks so much for your question,
You're petite with a wide diastasis and likely loose upper abdominal skin. if you absolutely don’t want the vertical scar, an extended tuck with high-tension technique might still give you a great improvement

I would suggest being treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.

Sincerely,
Dr. Emmanuel Mallol

Thank you for your question. An extended tummy tuck or possibly even a lower body lift (circumferential tummy tuck) would likely be the best option for your situation, as it effectively addresses the lower abdomen and the flanks and allows for the repair of the abdominal separation. It will also avoid the drawbacks of the fleur-de-lis tummy tuck, which would leave a vertical scar down the center of your abdomen. A detailed consultation with your surgeon is essential to discuss your options and ensure the procedure aligns with your goals of avoiding vertical scarring while achieving the best possible results.

Hi, according to your pictures, we can surely say that without vertical scar, you can’t get rid of the excess skin. In my opinion your benefits from this surgery will be much more than discomfort caused by scars

"I do not recommend the Fleur-de-Lis technique in your case. Instead, an extended tummy tuck or a belt lift would be the most suitable options. A belt lift offers the advantage of lifting the buttocks while also being a less traumatic procedure. Additionally, an interior muscle repair will be performed.

If you do not desire an increase in breast size, a breast lift without implants would be appropriate, utilizing the vertical incision technique with superomedial pedicle for optimal results."

Thank you for your questions. I think that an extended abdominoplasty with plication of your muscles and lipo of your flanks and back will give you a very nice result without having an obvious midline scar. I hope that helps.

Dear kdossett7,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

After undergoing massive weight loss, skin laxity is all but inevitable. This can at times be not just in the vertical direction, but also in the horizontal as well. A conventional tummy tuck mainly addressed vertical (up and down) laxity, If there is significant horizontal (side to side) laxity, your surgeon may recommend the addition of a vertical incision which we call a flour-de-lis abdominoplasty. This will bring in and tighten the skin of the torso more effectively than a standard tummy tuck but at the cost of the large vertical scar. In the old days when gastric bypasses were done via a vertica incision the decision was easy because the scar was already present. If there is no existing scar I explain to my patients the benefits of the fleur-de-lis vs a standard and ultimately they decide which they would like to do. I would say that most of them choose the standard and are very pleased with the results.

Thank you for the very good question. Judging by your photos I would recommend a mastopexy with implants, this will elevate your breasts and return volume and shape. For your abdomen, an extended tummy tuck is what is required. A fleur del lis is best suited for individuals who have had massive weight loss. Always try to avoid the vertical sac in a tummy tuck if possible.