Are all abdominoplasty/tummy tuck incisions from hip to hip?

The question is not how extensive the scar will be following the tummy tuck, the question is how extensive is the soft tissue defect that needs to be repaired. Limiting the incision to jus the anterior abdomen condemns the results to have massive "dog ears". Pleating and working out the excess skin requires extending the incision around to the flanks. In some cases a full belt lipectomy will deliver an optimal result. It is not inconceivable that a revision of a dog ear will be necessary in patients who have massive amounts of tissue to be removed.

The tummy tuck incision length will vary from patient to patient depending on the amount of excess skin that you have.  This usually will involve removal of a preexisting cesarean scar.  Also, Breast Implants can be inserted from an incision in the underarm area, but this is not always the best incision that can be used.  Discussing these options with your Board Certified Plastic Surgeon who performs a lot of these surgeries and can demonstrate excellent results to you is the best way for you to determine the best options for you.  

While hip to hip is common phrase to use, I like to create a custom incision for every patient so they get the best results. Some bodies need a longer incision then others. This is what is so fun to me and challenging in that no two cases are the same. I also love trans-axillary breast augmentation when done with an endoscope so you see what you are doing. The blind sweep technique is very quick and popular and can create excellent result but I like to see what I am doing which is why I use the endoscope! The incision is usually below or under the prior scar so it is removed. Good luck and see a few board plastic surgeons to find the best fit for you. Look at  before and after pics too as they really help. Good Luck!

Hello and thank you for your
question.  If you are an appropriate candidate for a tummy tuck, this can be done
through a low and short incision, all completely below the bikini line.  I place the scar below the level of a c-section scar and therefore the c-section incision is completely removed.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.  The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Thank you for your questions.  In general a full tummy tuck incision is from hip to hip.  A mini-tummy tuck incision may be shorter, though still longer than the typical c-section scar.  If the c-section scar is not too low and you have enough excess skin, then the TT scar can be placed at that level replacing the c-section scar (only one scar, not two.) We always try to achieve this, though it is not possible in certain patients.  Finally, saline implants can be inserted via the trans-axillary approach, but this is not a common approach in the US. I do not perform this approach because I feel the risk of implant malposition is higher. Seek a board certified plastic surgeon with a vast experience in TT and trans-axillary breast augmentation to answers all your questions and address your concerns. 
S. A. Earle, MD, FACS

yes most scars are hip to hip to allow excision of the excess skin.   If you stand and look in the mirror, you can see where the excess skin folds and where the scar needs to be.  You cause the c section scar if it is not too low.  Most surgeons will do this. Implants can be put in through the axillry ( arm pit) incision, belly button or under the breast.  It depends on your surgeons recommendation and type of implant.

In short - The scar needs to be a long as it needs to be in that patient to avoid dog ears. The more skin removed, the longer the scar. The scars take just as long to heal whether they are short or long and the same bathing suits/panties should be able to cover them as well.If the skin is loose enough the c-section scar can be where it is located. That is not always the case.Yes. In appropriate candidates the breast implants can be placed via a transaxillary incision.

Thank you for the question.  In our practice planning the incision line for tummy tuck surgery is done after careful communication of patients' goals and preferences. I find that marking patients the day before (or of) surgery, as much as possible, with the help of the patient's planned swimming suit or undergarment, helps when it comes to placement of incisions…  The length of the incision my will vary from one patient to another,  depending on factors such as the areas of "redundant" skin.
 In most cases, if a patient's C-section is in a favorable location (in other words, the patient is happy with where it is placed), it can be utilized (extended) for the tummy tuck procedure.  In occasional cases, if the C-section scar is too high or too low,  a separate tummy tuck incision is planned.
 Best wishes.

The incision length varies based on skin laxity and volume of skin.  Its like tailoring.  You cannot cheat on the seam if a longer one is needed (despite what people say about short incision TTs).  Implants can be placed simultaneously through a multiplicity of incisions.  The choice of incision depends on the surgeon and their experience.  A transaxilllary approach is blind unless you use an endoscope and is more prone to implant malposition.  Its not my favorite.  If you have a good natural inframammary fold, use that.  

The length of the TT incision depends on the length of the abdominal overhang. If the overhang is small then the TT incision will also be shorter. If the overhang is long then the TT incision will have to be longer and often extending from hip to hip.