Hello,Responses to your question have been vague ('it can be lower') or incorrect ('it will affect how tight the skin gets'). Here's the truth, the tummy tuck incision has been placed incorrectly by surgeons, including myself, basically since it's inception. The problem was, and is, the improper prioritization of getting the belly button hole out along with the skin being removed. To do that on most women required placing the incision high enough so that hole would be excised, leaving an unsightly scar in the middle of the lower abdomen. Instead of prioritizing the removal of the hole, it should be on proper placement of the lower incision. There is an exact place the scar should be to make it visually inconspicuous: along the border between 'aesthetic units' of the thigh, abdomen, and pubic triangle. When this is accomplished, there is almost always the need to also have a short vertical scar to close the old belly button hole in the skin. This is very minor visually, and leads to, as you said, a seamless appearance to the abdomen.Along with proper scar placement, there are three other maneuvers that makes for the most modern, sophisticated abdominoplasty available:1. Liposuction of excess subcutaneous fat. Once thought to be dangerous to healing of the skin when combined with a tummy tuck, more modern liposuction techniques allow this combination to occur with no increased risk to healing issues. 2. Direct removal of all deep fat, known as 'sub-Scarpal' fat. Recent anatomic studies of the blood supply to the skin of the abdomen show that circulation increases when this fat is removed, allowing blood flow to be diverted to the skin.3. Progressive Tension Sutures. This technique allows for even tightening of the skin from the top of the tummy to the bottom, giving the smoothest and tightest result possible with less risk of healing issues near the incision. It eliminates the need for drains, the most cumbersome and unpredictable part of a tummy tuck surgery that can be kept in place for weeks, which then usual leads to seroma formation. Finally, the risk of seroma in general is also nearly eliminated; in my practice it went from a 20% risk to 1% risk. Although more time is required to accomplish this, compared to older tummy tuck techniques the improved result and risk reduction to many complications make the extra time worth it for both the patient and the surgeon. Best of luck!
