Different Location and Direction of Tummy Tuck Incisions?

Why are some Tummy Tuck incisions straight across and some in a dramatic "u"? Is there an advantage to the "u"?

Doctor Answers 7

Patient choice governs the location of Tummy Tuck scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Aromagal,

First, we need to agree on the OBJECTIVES of a Tummy Tuck. I think most Plastic surgeons would agree that the goals put forward by Dr. Lockwood with his High Lateral Tension Abdominoplasty are a good starting point; Flat attractive tummy, feminizing the waist by narrowing it, some lifting of a droopy Mons pubis (the area over your privates) and some lifting and smoothing of thigh dimpling (aka cellulite).

The LENGTH of the scar is mandated by the amount of loose skin that would need to be removed. (Much like the length of a hemming stitch line depends on the amount of cloth being hemmed).

The SHAPE of the scar is governed by the choice of underwear and fashion (see further) as well as the extent of skin laxity. Curving an incision allows removal of more skin without necessarily making the scar look longer.

Finally, the LOCATION of the scar depends on the surgeon's preference as well as on the patent's choice of underwear and bathing suits. We try and hide the scar as musch as possible within your clothes. While the scar will be permanently visible when nude, we attempt to hide it within whichever style of underwear you plan on wearing from now on. Knowing that fashions DO change - I would advise you be conservative and pick as a guide underwear that will NOT go out of fashion. Then, the upper rim of the underwear will serve as the upper border under which the horizontal scar will be placed. We curve it sideways to follow the underwear and upper thighs - but the length is dictated by the extent of skin we need to "hem" off.

Pick a plastic surgeon who explains this to you and allows you to determine the location of the scar WHILE UNDERSTANDING that trade offs of a scar that is too low or too high on the thighs.

I hope this was helpful.

Memphis Plastic Surgeon

Designing scars for tummy tucks - you have input!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A tummy tuck ("abdominoplasty") requires creation of a longish scar across the lower abdomen, and usually also around the belly button.

During a tummy tuck, excess skin and fat is removed from the lower belly, and the muscles of the abdominal wall are brought together by a technique called "rectus fascial plication".

Adbominoplasty is really a three-dimensional operation, serving to corset your midline from the inside, and tuck excess skin and fat on the outside! It is an incredible procedure for some women who are good candidates.

The location of the incision can be designed to fit within your normal swimsuit or undergarment lines.

Some women wear very low-cut bathing suits or jeans, and wish their scar to be as low and horizontal as possible.

However, other women may wear a more high-cut undergarment or bikini bottom, and may wish the scar to lie slightly higher. Most women know which cut or style of bottom flatters their figure most, and tend to stick to that style.

You can bring your undergarment with you to a consultation with a Board-Certified Plastic Surgeon and show your Plastic Surgeon where the ideal location for the scar to lie, if possible.

Remember, however, that styles and fashions can change. Scars are permanent, but fade dramatically with time.

If you are seriously considering a tummy tuck, stay involved with the planning process and don't be shy about asking your Plastic Surgeon to tailor the procedure so that it suits your body, fashions and lifestyle the very best!

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

Karen M. Horton, MD
San Francisco Plastic Surgeon

Location of tummy tuck scars can be individualized

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

As you noted there are options to the location of the tummy tuck scar. In general the central portion of the scar is straight, usually within or just near the top of the natural hairline. The scar can then continue mostly straight to the side, or curving up more like a "U" as you suggested.

The majority of the time your surgeon can discuss the options with you and choose a location that best fits your body as well as your preference for style of underwear or bikini bottom. For example some years ago it was fashionable to wear higher "French cut" bikinis and therefore to have the scars go up much higher on the side so they may be more hidden. Currently the fashion trend is for lower cut jeans and many women prefer a lower straighter scar. I will ask patients during the pre op visit what there preferences are and if they have a favorite style of underwear or bikini bottom to bring that with them for their "marking" prior to surgery. An outline of the margin of the garment is made and most of the time the scar may be left so it is more hidden.

Patients will frequently ask why some scars are longer than others. In general the more skin that removed in a vertical direction the longer the scar ends up. The tummy tuck procedure involves much more than just removing skin. Most patients benefit from tightening the abdominal wall. This part of the procedure is what allows for the abdomen to end up with a great shape and contour. Many patients also benefit from appropriate liposuction.

John E. Gross, MD
Los Angeles Plastic Surgeon

You might also like...

What are tummy tuck scars in different positions?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Aromagal. As you pointed out the position and curve of the scar is variable in tummy tucks. Sometimes, it is the surgeon's preference that drives this decision. For my patients I design the location and curve of the scar according the bikini bottom style my patient prefers. Even if you are not going to wear a binkini at the beach, it is nice to put on your underwear and have the scar completely covered. Underwear varies-some are cut high on the thigh, the waistband can be higher or lower, the width of the waistband varies, etc. I mark the outline of the preferred panty design pre-op and make sure the scar falls within this outline. Keep in mind that the position of the scar is very difficult, if not impossible, to change after the fact. If the style trend changes, you may be stuck. For example, years ago everyone wore bathing suits with a very high cut out of the thigh. In order for a tummyt tuck scar to be hidden while wearing this style, the scar had to curve up fairly high. When low riders became popular, some of these scars were visible above the waistband of the low rider jeans. Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Tummy Tuck scar locations

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The location of the tummy tuck scar and it's shape has to do with your particular anatomy and personal preferences. Many patients today desire a very low scar which does not extend in a U or V shape at the sides; this is due to the fashion trend of low-rise jeans and clothing. Usually, I will have a patient wear regular underwear or swimwear the day of surgery, which assists in placing the incision in an acceptable location and position.

The patient and surgeon should decide together the final location of the scar. Remember however, that scars can slightly migrate over time and that the ultimate location of your scar may vary somewhat from the position it was marked on the day of surgery.

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 410 reviews

Tummy Tuck incision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 The Tummy Tuck procedure involves making an incision just above the pubic hairline and then removing excess skin and fat. The incision is placed well below the panty line so that it can be easily concealed with underwear or a bathing suit. The skin of the abdomen is then pulled down tight, and sutured back together and if the patient has abdominal muscle separation, this is corrected.

Francis X. Fleming, MD
Kennewick Plastic Surgeon
4.5 out of 5 stars 18 reviews

Patient Has Choice in Tummy Tuck Scar Location

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
In general the type of incision that we use for tummy tucks are commensurate with the current style of clothing, which today tends to ride lower on the hips versues previous styles which rode much higher. Generally speaking you have a choice, and placing the scar lower tends to be the more popular choice currently.

Burr von Maur, MD
Orange County Plastic Surgeon
4.6 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.