What causes the vertical indention under the skin down the abdomen after a Tummy Tuck?

This has to do with the way the surgeon plans and executes the tummy tuck.  Look at pictures.  If the surgeon creates this line in their photos, they will likely create it in you.  I have never created this line, but have seen it before in other surgeons work.

    If you do not already have this line, it does not have to be created.  Kenneth Hughes, MDLos Angeles, CA

The vertical indentation after a tummy tuck should be limited to the upper abdomen only. That is, from the bottom of the breast bone to the belly button only. No indentation should be created below the belly button. If you look at pictures of models in magazines, you will see this vertical indentation. This is the linea alba, the depression between the two rectus muscles, and some have a slight indent in the horizontal plane as well, defining the inscriptions, or the "six pack". This is more evident in athletic males. Most women who are somewhat overweight, loose this anatomic definition, but it can be recreated during surgery. If you do not want this definition, you need to communicate it to your surgeon. This does not need to be done with a standard, average tummy tuck that most surgeons do, but it is done in women who desire advanced body sculpting.

Great question! Some doctors find it aesthetic, or good looking, to remove the fat in the midline to make the abs look more "etched", when really there is no abdominal definition really present. It creates an illusion. Some surgeons do use quilting sutures in the midline which may accentuate it. Best bet is to have an open conversation with your board certified plastic surgeon about your desires and ways to get the outcome you expect. Good luck!

Thanks for your question.  I suppose the best advice is to visit with a board certified plastic surgeon that can share before and after photos of their work with you.  During my consultations I frequently review photos with patients as a communication tool which helps us develop the best plan.Best WishesSteven Camp, MD

A photo and casehistory would be helpful in answering this.  I have seen an occasional case presented here with such a problem, and my assumption has been that little or no separation of the skin from the abdominal muscles has been done, as if one tried to do a muscle repair without a TT.  Tightening the muscles without freeing up the skin will drag the skin toward the center, causing the crease. All the best.