Why are the scars for tummy tucks so high on most pictures when the new panty styles are low and would in fact show it? (photo)

It's a great question. The scars can be kept below the clothing if you understand that there's a chance of having a small vertical midline scar that's low on the tummy. Regarding the scars, it's important to understand how the operation works. An incision is created low on the abdomen, a second incision is created around the belly button, the skin and fat from the tummy is lifted from the abdominal wall (the belly button stays attached to the abdominal wall), the muscle repair is performed above and below the belly button, the skin from the belly is pulled taught and trimmed at the level of the original incision. A new hole is created for the belly button and it is brought through the skin and sewn in place.Ideally, the hole where the belly button used to be is removed with the excess skin. This leaves the patient with a single incision on the lower part of the tummy. If there is not enough excess skin, some surgeons will move the lower incision higher to make sure that they can remove the hole where the belly button used to be. The other option is to keep the incision low, and if the belly button hole cannot be cut out with the excess skin, the hole is closed in a vertical fashion. This leaves the patient with a lower transverse incision with a small vertical scar (inverted T scar). In this situation the low transverse incision is covered by clothing and there may be a small vertical incision in the midline of the tummy. In my opinion this small vertical scar is less noticeable than raising the transverse scar above the level of clothing (waistband on jeans, etc.) in order to remove the belly button hole.

The treatment of keloids and scars from a plastic surgery procedure
such as a tummy tuck begins with early treatment. I would suggest
application of Plato's Scar Serum once the skin has epithelialized,
laser with microfractional RF and ablation, and pulsed dye laser.
Surgical revision is rarely needed in our office. 
Dr. Karamanoukian
Realself100 Surgeon

Most plastic surgeons will place the scar at the level of your C-section scar if it is low and where you want it. This requires that the skin above the belly button can be stretched enough to replace the skin that was removed, which isn't always possible. In that instance, the scar can either be a little bit higher or the hole where the belly button was can be sewn up vertically, leaving an upside-down "T" which is usually preferable. Post op pictures should be done with the scar visible, so the "photo panties" may be positioned intentionally to expose the scar. This could make it appear higher than it is.

 The surgeon should have the ability to control where the scar will end up to suit your desires. I have my patients bring in an example of their typical underwear or bikini bottom for marking to ensure the scar is completely hidden by their most revealing clothing.

In general, in an abdominoplasty, we try to locate the scar as low as possible. If there is a pre existing c section scar, we almost always remove it. However, the other factor in a full tummy tuck is the preexisting location of the belly button. The higher it is, the more skin has to be removed (because all of the skin between the lower incision and the belly button needs to be removed). And the higher the belly button, the higher the resulting scar will end up. Occasionally, with a high belly button, the alternative if the goal is as low a scar as possible, would be to leave a short vertical scar in the center (above the horizontal scar). This scar results from closing the "hole" in the abdominal flap where the belly button used to go through it. Patients can be provided this choice. In my experience, more patients would prefer a little higher scar than a short vertical scar. 

Multiple aspects influence the final location of a scar in a tummy tuck. Patient factors including skin redundancy, soft tissue elasticity, and aversion to a mid-line vertical scar influence where the transverse component will be. Discuss these issues thoroughly with your Plastic Surgeon to make sure everyone is on the same page.Best of luck!

Techniques can vary by practice, though we have a preference for a very low scar, usually along the traditional c-section line and straighter toward the hip to keep the scar concealed under current fashion.We suggest you show your surgeon what you wish to wear and discuss openly what you expect.

The question you ask is very common, and the answer relates to where your abdomen ends and your thigh begins. A C-section scar is usually quite short and is above the pubic area on the abdomen. If you are sitting on a bed the C-section scar does not extend onto your thigh. But the Abdominoplasty scar is longer and extends beyond a standard C-section scar. I mark patients sitting down initially to see the point where the abdomen ends and the top of the thigh begins (usually where loose skin begins to hang over). I place the planned incision line on the abdomen and not the thigh, as the thigh needs to stretch and move more than the abdomen. Panties often start below the highest point of the thigh and actually cover the front of the thigh below the abdomen. We try to keep the Abdominoplasty scar as low as possible to be "bikini friendly", but we cannot place it on the thigh. Please ask your Plastic Surgeon to point out the top of your thigh skin to better explain the position of the "Tummy Tuck" scar.

You ask a very good question.  Actually abdominoplasty scars have followed bikini and underwear styles.  Some older pictures may show incisions that fall in the higher "French Cut" bikini line. Having trained in the era of the lower panty line, I use a technique that helps place the scar in a inconspicuous location. Your old C-section scar will also serve as a road map for your plastic surgeon during surgery.  Thank you for your question and good luck with your upcoming surgery!