Hi. I am questioning the consultation I had recently about a tummy tuck. I have minor distasis from my 3 pregnancies. I'm currently at 12% body fat and very fit, I am 5'4", but have a long torso. I was told because of my long torso it's likely I will need a vertical incision as well. And he said there was no way to even give me an idea of how long that vertical cut would be until he was in there and doing it. I measured the distance from the top of my belly button to my scar is 5.5 inches.
January 21, 2016
Answer: Is a vertical incision necessary for a Tummy tuck with a long torso? The issue is not really that you have a long torso, it is more a factor of having a high belly button and how much loose skin that you have above the belly button.In a traditional tummy tuck, an incision is made around the belly button which stays in its original position. The skin is pulled down and the incision made around the belly button is removed with the excess skin. You end up with a long horizontal incision and an incision around your belly button.In patients that do not have enough skin above the umbilicus to pull all the way down, there are basically two options. You can detach the belly button from the muscle and not cut around it. The belly button is then pulled lower when the excess skin is removed and reattached at a lower level. This works well for women whose excess skin is all at or below the belly button. The problems occur when there is loose skin above the belly button and when you pull it down enough to make it nice and flat, it positions the belly button too low on the torso and too close to the mons-this looks weird! If this same patient had a traditional tummy tuck where you leave the belly button attached to the muscle, the hole cut around it would not pull down low enough to be cut out with the abdominal skin. When this happens, the hole is closed up with a short vertical scar extending one to two inches up from the horizontal abdominal scar.It really takes an experienced surgeon to assess your tissue and determine the best approach because once you commit to one option, you cannot change course because you have to leave the belly button attached to either the skin or the muscle for it to have blood supply to survive.I discuss these options with all of my tummy tuck patients who have a high umbilicus and minimal laxity above it. If their goal is to have the flattest tummy possible, a short T-scar with the belly button left in its original position is best. If they don't want an incision around the belly button or a short T-scar, the umbilicus can be elevated with the skin and brought lower, but they may have to accept that they will have either a low belly button or some residual skin laxity if the belly button would come down too low and it has to be left higher to look normal.I don't see any need for you to need a long vertical incision. Some surgeons do this technique, but it is rarely if ever necessary except in massive weight loss patients.
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January 21, 2016
Answer: Is a vertical incision necessary for a Tummy tuck with a long torso? The issue is not really that you have a long torso, it is more a factor of having a high belly button and how much loose skin that you have above the belly button.In a traditional tummy tuck, an incision is made around the belly button which stays in its original position. The skin is pulled down and the incision made around the belly button is removed with the excess skin. You end up with a long horizontal incision and an incision around your belly button.In patients that do not have enough skin above the umbilicus to pull all the way down, there are basically two options. You can detach the belly button from the muscle and not cut around it. The belly button is then pulled lower when the excess skin is removed and reattached at a lower level. This works well for women whose excess skin is all at or below the belly button. The problems occur when there is loose skin above the belly button and when you pull it down enough to make it nice and flat, it positions the belly button too low on the torso and too close to the mons-this looks weird! If this same patient had a traditional tummy tuck where you leave the belly button attached to the muscle, the hole cut around it would not pull down low enough to be cut out with the abdominal skin. When this happens, the hole is closed up with a short vertical scar extending one to two inches up from the horizontal abdominal scar.It really takes an experienced surgeon to assess your tissue and determine the best approach because once you commit to one option, you cannot change course because you have to leave the belly button attached to either the skin or the muscle for it to have blood supply to survive.I discuss these options with all of my tummy tuck patients who have a high umbilicus and minimal laxity above it. If their goal is to have the flattest tummy possible, a short T-scar with the belly button left in its original position is best. If they don't want an incision around the belly button or a short T-scar, the umbilicus can be elevated with the skin and brought lower, but they may have to accept that they will have either a low belly button or some residual skin laxity if the belly button would come down too low and it has to be left higher to look normal.I don't see any need for you to need a long vertical incision. Some surgeons do this technique, but it is rarely if ever necessary except in massive weight loss patients.
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January 21, 2016
Answer: Is a vertical incision necessary for a Tummy tuck with a long torso? (photos) If someone is in good shape with a long torso, it is not always possible to remove all the skin between the incision and the belly button. In that case, the original incision made around the belly button cannot be removed. I will then close that with a small vertical incision low on the abdomen. Another option is to float the belly button and slide it lower on the anterior abdominal wall. This will avoid a vertical incision all together. You can see some of my small vertical incisions on my before and after photos. Good luck!
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January 21, 2016
Answer: Is a vertical incision necessary for a Tummy tuck with a long torso? (photos) If someone is in good shape with a long torso, it is not always possible to remove all the skin between the incision and the belly button. In that case, the original incision made around the belly button cannot be removed. I will then close that with a small vertical incision low on the abdomen. Another option is to float the belly button and slide it lower on the anterior abdominal wall. This will avoid a vertical incision all together. You can see some of my small vertical incisions on my before and after photos. Good luck!
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