Are my Tummy Tuck Expectations Realistic?

I am booked to have a Tummy tuck in September and want to know if my expectations are realistic, I have had 3 C-sections and want this same scar line used, i want the incision done low and straight (NOT the smily face) stitching done small and close together. When i tell my surgeon this at consultation is this achievable and realistic?

Doctor Answers 5

Tummy Tuck and Realistic Expectations in Regards to Scar?

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Thank you for the question.

You are wise in trying to achieve “realistic expectations” in regards to your tummy tuck operation. Exactly where your incision line will be placed will depend on your specific anatomy. For example, if patients have a relatively high riding umbilicus, the incision lines may  differ compared to patients who have a relatively low umbilicus ( or a longer torso).  In other words, there are some specific anatomic variations between patients that will determine where the best placement of incision line for tummy talk will be. Sometimes  a short vertical incision line may also be necessary (depending on the patient's anatomy and the need to close  the umbilical opening).

Although most plastic surgeons will attempt to keep  resulting scars as fine as possible, patients should be aware that scars can spread and that abnormal scarring ( hypertrophic or keloid) can occur despite best efforts.  Also, wound healing problems/separation may also occur despite best efforts.

Remember to also discuss the appearance of the scar  around the umbilicus;  this will be the only scar visible when you are wearing a two-piece swimming suit.

In the process of achieving realistic expectations make sure you understand the potential risk/complications and worse case scenarios that can occur with scarring after tummy tuck surgery.

I hope this helps.

Tummy tuck patients usually very happy.

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Your expectations sound alright except that the tummy tuck scar will be longer than the C section scar.  But don't tie your surgeons hands.  You are paying him or her for good judgement.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Tummy Tuck Expectations

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Hi there,

Yes is the answer:  realistic and sensible.

Your expectation should be that the C section scar is entirely removed by the tt incision, which can indeed be low and straight.  

A good thing to do is take some typical underwear that you would mostly wear with you to the consultation.  TT incisions are always least obvious when placed low in the centre, then under the line of the typical underwear you use.  Women tend to wear underwear in a consistent style which suits their body shape, and the scar can be tailored to best suit your preferences.

As far as stitches go, in general the stitches should be buried so there are no stitch marks on the skin.  There is some variation in this between surgeons, but a fair question to ask your surgeon is "what do you do to give me the best possible scar?".  Each surgeon will have a preferred closure technique to achieve this aim.

Good luck.


Expectation and Results--Tummy Tuck

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It is excellent to ask about your expectations and if they are realistic. 

  • C-section incision--there is no reason why this cannot be used again unless it is higher than you and your surgeon think is appropriate. However, the incision will most certainly be longer than the c-section incision.As a rule of thumb, it will need to be an inch beyond the level of skin excess to each side.
  • Straight line incision--this will depend upon the length. If you mark out the level of the c-section and extend it far enough to remove all the skin and continue it as a straight line, as the incision crosses onto the thighs it would be visible in most swimsuits or undergarments. The incisions we prefer follow the direction taken by swimsuits and undies, which in turn follow our anatomy. That is why it curves or bends for most patients. 
  • Most of us use buried sutures for tummy tucks, usually a running suture for the top layer, so I am not sure how to answer this question, but with some more explanation your surgeon will be able to.

What we want to accomplish is a nice contour improvement with incisions that are long enough to do the job at hand but not longer, and incisions that are as well camouflaged and hidden as possible.Your surgeon can help explain where the incisions will be, and if your are compromising your outcome by limiting the length or position of the implants. With that information, you can make an informed choice.

Best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Tummy Tuck Incision Placement around C-Section Scar

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It is wise of you to look for a realistic result. A Board Certified Plastic Surgeon can work with you on what that means for you. As with most plastic surgery, the results you can expect are heavily dependent on your anatomy. Without an exam or several good quality pictures I am unable to comment on your body specifically. In general, an abdominoplasty incision will be longer than a C-section scar. Additionally, the curve to which I think you are referring when you say "smiley face" is indicated to prevent the scar from extending out onto the thighs across the hips. There is a lot more motion to that area and the scar isn't as stable and is prone to separation. Without the appropriate length of incision it isn't possible to remove all the necessary fat and excess skin. Discuss the method the surgeon uses for closing the incision at your consultation so you will understand the process. Ultimately it comes down to trusting your surgeon. If you chose to let them operate on you, let them do it the way they have learned that produces the best results. If you try to control what they do and they alter their usual technique for what you (who isn't a surgeon) wants, you won't get their personal best. Good luck on your upcoming procedure.

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.