Do I need full tummy tuck? Will I need vertical incision? Can incision be super low? (Photo)

I believe I have diastatis recti after having my 3rd child almost 2 years ago. I'm 5'4" and about 115 pounds. Do I need a full tummy tuck with incision hip to hip? I've seen some where they also have a vertical scar - will I need that? I'd like the scar to be super low but I know it depends on each person. Does it look like they could put scar super low?

Doctor Answers 11

Full Tummy Tuck Needed?

Yes your photo does suggest that you have rectus diastasis and a suture plication of your rectus muscles would be an important part of a tummy tuck procedure on you. You certainly do not need a vertical scar. This is only needed in patients who have very extensive skin laxity. Regarding the transverse incision, which is component of any tummy tuck procedure, it is obviously preferable to keep the incision as low as possible so that it is hidden by most clothing and undergarments, or potentially even by a two piece bathing suit. 

Your belly button looks somewhat high in your photo and you don't appear to have an excessive amount of skin laxity. If this is correct, then you may be a candidate for a modified abdominoplasty in which your belly button is released from underneath to allow for the plication or tightening of your rectus muscles and then it is sutured back down in a slightly lower position. With this approach not as much skin is typically removed and the lower scar is therefore not as wide. A tummy tuck procedure should not be a one size fits all kind of operation. It should be tailored to your specific anatomy and will frequently be combined with some liposuction of the hip/flank region to give you an overall better contoured torso. 

Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Ideal Candidate for Tummy Tuck

Hello, thanks for your photos and your inquiry. You are a great candidate for a tummy tuck. You won't need a vertical incision at all. With a hip to hip super low incision you would do great. The abdominal muscle wall will be repaired and the extra skin will be removed. If you desire you might have liposuction in your waist and flanks so you can achieve a beautiful hourglass figure, which is so appealing. 

Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 253 reviews

Do you need a full TT?

Far more important than deciding if a tummy tuck is for you is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let him explain why one technique may be better than another and if you need a tummy tuck. Many board certified plastic surgeons provide a free first time consult and you should take advantage of that!
See the below link on some suggestions on finding the most qualified Plastic Surgeon for you!The best clients are patients who are healthy but have EXCESS SKIN OR FAT that does not respond to diet and exercise. Patients who have undergone SIGNIFICANT WEIGHT LOSS and have hanging skin. Women with loose skin and stretch marks FOLLOWING PREGNANCY, as in your case. Anyone with LOSS OF SKIN ELASTICITY. Patients who are unable to tighten the abdominal wall with exercise. If you have loose or sagging abdominal wall skin; often associated with relaxation of the anterior abdominal wall muscles (frequently secondary to multiple pregnancies)

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 159 reviews

Do I need full tummy tuck? Will I need vertical incision? Can incision be super low?

The length of the scar depends entirely on how much skin needs to be removed. The more skin, the longer the incision. After tightening your muscles, you may have a substantial amount of skin that needs to be removed. As to a vertical incision, that comes form the old belly button site being transposed downward. The lower the  horizontal incision is placed, the greater the chance you will need a vertical incision also as the old belly button site has longer to move.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews



You will need a comprehensive abdominoplasty. Liposuction is performed first to de-fat the abdominal skin.  Next a super low incision is made that runs along the thigh-abdominal border laterally and  just above the labial cleft centrally.  Skin is elevated and the abdominal musculature is fixed with permanent sutures. Progressive tension sutures are placed to optimize skin tension along entire abdomen, but also obviating the need for drains after surgery.  The belly button is delivered through a hole placed in the re-draped skin, and the old belly button hole would likely be closed with a small vertical incision, that will literally disappear in time. Go visit a few ABPS certified/ASAPS member surgeons that perform drainless abdominoplasties.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Do I need full tummy tuck? Will I need vertical incision? Can incision be super low?

Thank you for your question and photos. Based on your photos, you will need a full tummy tuck. This does not mean you will need a hip to hip incision. I, personally, like to place the incision at the pubic bone level or 4-6cm from the top of the labia in the pubic area. With special instrumentation, the whole muscle separation can be repaired through a small C-section type of incision. You have a high ridding belly button and from the photos you seem to have good skin. The belly button possibly can be floated, but if determined on the physical examination that you do have significant skin laxity, than the belly button is left attached to the fascia. In this case, you would have a small vertical scar low in the abdomen if the belly button opening cannot be removed inferiorly. You would also benefit from liposuction of your hips and waist, although you did not provide any back photos. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Tummy Tuck

Thanks for the question and the good photos. Dr. Grenley  has given you an excellent summary. Some surgeons do place the scar too high, and it cannot be corrected later so make sure you see a board-certified surgeon that is highly experienced in this surgery. You may also be a candidate for a variation of the tummy tuck called the "Floating Bellybutton".  This technique is used when there is not a lot of skin to be removed but the patient needs a muscle repair from the top to the bottom of the abdomen. It allows us to elevate the umbilicus with the skin, off of the muscle, repair the muscle, and then put the umbilicus back where it belongs with a modest tightening of skin and a very low scar.  It would take a consultation and full examination to determine which of the several types of tummy tuck would best suit your needs. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Do I need full tummy tuck? Will I need vertical incision? Can incision be super low?

Yes, you would need a full tummy tuck for complete repair of your diastasis recti with fascial plication, and for complete tightening of your tummy skin both above and below the belly button. Yes, your incision can be placed low, as it always should be, so that the long scar is well hidden below underwear or a two piece swimsuit. In my opinion, there is NO justification for placing the scar any higher than that. If you do not have enough excess skin in the upper tummy for the old belly button hole to be completely removed as the skin is redraped downward, then the old hole needs to be closed with a short vertical scar. Some plastic surgeons will elevate the level of the long lower scar if the old belly button hole will not come down far enough in order to avoid a short vertical scar. This makes no sense to me. Now the long scar is too high and hard to hide, it often does not heal as well, it cuts across the normal curvature of the lower tummy, it can raise the level of the pubic hair, and there is no way of lowering it when a patient complains that it is too high. A short vertical scar, if needed, is a small price to pay for the other benefits of a tummy tuck and a low scar that is well-positioned where it can be better hidden.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Do I need full tummy tuck? Will I need vertical incision? Can incision be super low?

Thank you for your question. Based on your photos, you would benefit from a full tummy tuck procedure. A full tummy tuck removes skin and tightens the abdominal wall above and below the belly button. Your photos demonstrate a bulge in your abdomen from the top to the bottom. This occurs because the abdominal wall has stretched during pregnancy. A full tummy tuck incision is from hip to hip and there is a second incision around the belly button. Sutures are used to tighten the abdominal wall. The lower scar can always be kept low, but it's important to understand that there may not be enough excess skin on your tummy for the belly button incision to be removed completely. When this occurs, the hole where the belly button used to be is simply closed with sutures and leaves a small vertical scar on the lower abdomen, which heals quite nicely. This small scar is definitely less noticeable than moving the hip-to-hip incision higher on the tummy, where it isn't covered by underwear, bikini bottom, or day-to-day clothing. In my office, I mark patients for surgery while wearing underwear, or bathing suit bottom, so that the lower scar is hidden by the underwear/bikini. Make sure to see board-certified plastic surgeons when considering any tummy tuck surgery.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 38 reviews

Tummy Tuck

It's my pleasure to answer your question.You are a candidate for the Tummy Tuck surgery. Abdominal wall muscles are repaired and the extra skin is removed.Sincerely,Dr. Aramis Vega

Aramis Vega, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 21 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.