Will I Need a Small Vertical Incision for my Tummy Tuck? (photo)

Thank you for your question and photos.  If two surgeons recommended that you compromise with a small vertical incision above your TT scar...I would heed their recommendations.  The have had the benefit of examining you and are interested in keeping you safe and giving you the best cosmetic result.  Base on your photos you have a long torso, high belly button and not a tremendous amount of laxity...these are observations and can only be confirmed with examination.  In this situation, leaving a small vertical scar where the original belly button exited is the safest and most prudent way of avoiding over resection and skin necrosis and wound separation.  These are all complications that you should avoid.  A small vertical scar that heals well and fades with time is a small price to pay for a safe and uneventful recovery.  All the best.

There are multiple options for placement of the scar and for the type of abdominoplasty. Each option can result in a reasonable improvement, but each has their its advantages and disadvantages. A lower placement of the incision and removing the C-section scar is a reasonable option.  There is a long distance between a high umbilicus and a low C-section scar. Sometimes there is not enough looseness and excess of the skin to safely remove the old hole from the incision around the belly button (umbilicus), so a small vertical closure of that incision is performed  in order to avoid complications from an excessively tight closure of the tissues. Another option is a second horizontal scar above your C-section scar, which is usually less desirable.

Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure may not be in your best interest. I would suggest that you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with.

You should discuss your concerns with that surgeon in person.

Robert Singer, MD  FACS

La Jolla, California

Even though your C-section scar is low, the normal location of the lower incision for an abdominoplasty is about 5-6 cm above the clitoral hood. And it appears as if your C-section scar would be removed with the surgery anyway. I would suggest that you will likely not require the vertical incision. With that being said, you still have a small risk of requiring that incision, so you need to be prepared for it, just in case. It really is impossible to tell for sure with photos alone.