Tummy Tuck Low Scar Technique? (photos)

Most plastic surgeons start their tummy tucks by cutting across the abdomen at the level of the belly button. Then they dissect towards the breasts and pull the skin downward and cut off as much skin as possible. This results in many scars that are pretty high and too visible to conceal in a 2 piece bathing suit. Another technique is to start low where the scar will be nicely conceived and 'tailor tack' by detaching the belly button, pulling the skin apron down towards the pubis like a window shade and cutting off the excess at the bottom and closing the old belly button hole as a small vertical line. 

Thank you very much for sharing your concerns with us. It is very important to discuss with your plastic surgeon how will be the resultant scars after surgery.In the Tummy Tuck the scarring is hidden in the panties line. You will change abdominal sagging skin, fat tissue and stretch marks by an aesthetically acceptable scar. If you have a vertical scar component (like an inverted "T") probably the skin didn't reach down, and needed to do that to get a safety closure.Kind regards,Dr. Emmanuel Mallol Cotes.-

Keeping the scar low and hidden gives a much nicer result. If there is not a lot of skin, an incision can be kept very low but may require a small T part- which wouldn't be as noticeable as the dark line (linea nights) you already have.An exam is necessary to determine if it is loose muscle and/or visceral fat. Consultation with a plastic surgeon is recommended to discuss your options and expectations.

When someone has a very full abdomen from internal fat deposits, it is usually best to lose some weight before surgery. See a board certified ASAPS plastic surgeon who will check your weight and measure your proportions. Low incision is always the goal of a tummy tuck and is often times discussed before surgery. Circumstances sometimes preclude the surgeon from achieving a low incision. They include previous scars, tight fascia and internal adipose (fat) tissue. Good luck...

I am surprised when I see high scars but most doctors will place it low. I agree with the bathing suit technique and often use it. You can discuss this with your doctor and see their before and after pictures. Good Luck! 

Thank you for your pictures. In my opinion, the position of the scar is based on good pre surgical planning.  The amount of excess skin can play a factor.  With the right pre surgical planning you can have a low surgical scar

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 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…In most cases, the tummy tuck incision can be kept very low, usually at or below  the pubic hair line (or at or below an existing C-section scar).The use of the progressive tension relieving suture technique (sutures placed between the abdominal wall flap and the underlying abdominal wall fascia) allows us to keep the resulting scar low and relieve some of the tension upon the tummy tuck closure.  Reducing tension upon the incision line helps keep scars as far as possible.Sometimes, especially for patients with a relatively short torso and/or minimal redundant abdominal wall skin, a short vertical scar is necessary ( in addition to the usual transverse tummy tuck scar). This vertical scar results from closure of the previous umbilical opening and prevents excessive tension upon closer in the midline of the tummy tuck incision line. If this vertical incision is not used, patients may end up with high scars, wound healing problems and/or wider scars. Patients should keep in mind that the lower the incision line used for tummy tuck surgery, the less skin can be removed at or above the umbilicus.  This may be especially relevant for patients who have stretch marks and/or piercings above the umbilicus.  Sometimes, patients elect to have their incision lines placed higher so that more skin and/or an existing supra umbilical piercing can be removed  during the tummy tuck procedure.  Always best to communicate your goals, concerns, and questions directly with your plastic surgeon. Best wishes.

Placing the scar low is a matter of assessment and planning.  Keeping it low to be hidden by clothes or undergarments is always the goal.  Higher riding scars result from tension or their high waist anatomy.  A good evaluation is necessary to predict the location of the scar.  Sometimes wearing your normal undergarment and marking the upper and lower border can help position the scar in that area.  Best wishes.

An exam is needed to see approximately at what level your scar could be. The positioning of the scar depends on a number of factors. These include the surgeon's preference, the amount of skin laxity and the patient's bodily dimensions. If it is a long distance from the intended scar position to the top of the belly button sometimes a small vertical scar below the belly button may be necessary to keep the scar low. These things are easy to demonstrate in person. Consider an in person consult with a plastic surgeon to get your questions answered more completely. 

the goal is to place the scar very low on the abdomen so as to be able to easily conceal the scar in a bikini, underwear, etc.  an in person consultation can show you where the scar could be placed - I often draw this with a marker for patients to see during their consultation.  consult with a board certified plastic surgeon to review the specifics of your situation.  good luck.