Why do some ladies have a cut/scar down the middle (vertical) on their tummy as well as the horizontal scar at the bottom?

Dear VA29, A vertical scar should be extremely rare. In 26 years of practice and thousands of tummy tucks I have never done the vertical scar from the chest bone to the pubic bone unless the patients had a gastric bypass surgery and had already a vertical scar from that procedure. Even in gastric bypass surgery it might not be necessary since many are done endoscopically. Now, if the skin of the upper abdomen is not loose enough or in redo tummy tuck, there might be a small vertical scar in the lower abdomen, which is the location of the old belly button. It is very important that you consult with experienced board certified plastic surgeons. Check their before and after pictures to make sure that you like the results. Best of luck, Dr Widder

I tell my patients who have a very, very large amount of skin to be removed that a vertical incision is sometimes required with a horizontal one to get the best results.

In almost all cases, the tummy tuck does not involve a vertical component. A relatively high belly button may involve a small vertical component, and a great deal of horizontal skin laxity may require a longer vertical incision. Find a plastic surgeon with ELITE credentials who performs hundreds of tummy tuck procedures each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Thank you for your question. A full scar T scar from top to bottom with a horizontal scar is a fleur de lis tummy tuck which tightens skin both up and down and side to side. It is usually used for people who have had massive weight loss.Some patients can have a small vertical scar above the pubic midline in a standard tummy tuck. In most cases in a standard tummy tuck all the skin from the top of the belly button and below is thrown away leaving just a horizontal scar. If a patient is tight on rare occasions it is necessary to leave the old belly button hole but close it up vertically leaving a small vertical scar above the pubic midline. This may be of benefit to patients that need more than a mini tummy tuck to remove excess skin or where the goal is to remove as many stretch marks as possible. It may occasionally occur in a very tall patient or a patient who has a high riding belly button.A pinch test by your surgeon and full evaluation will help you to decide which option is best for you. I hope the link below helps.Best wishes.

The procedure you are describing is called a Fleur de Lis or Inverted T tummy tuck. It is used to correct flank and upper abdominal skin excess in patients. It is effective but the scars can be significant. This procedure is also associated with a higher wound healing complication rate at the T junction since this is the area where there is the most tension. Consult with a surgeon experienced in body contouring and all available techniques before committing to one procedure over the other. The technique used should fit your needs. Best wishes.