Why would thin person need long vertical TT scar?

Hi there and good question.
The amount of skin laxity, position of the belly button and position of the horizontal incision are the biggest factors that determine whether or not someone will need a small vertical incision as well. The more skin laxity you have, the less likely you will need that vertical incision. The lower the belly button is on the abdominal wall, the less likely you will need the vertical incision. And lastly, the lower the horizontal incision is placed (low incision is a good thing as it hides in the underwear line and gives a prettier overall result) the more likely you will need a small vertical incision. It is difficult to definitively predict in advance whether or not it is needed so it is something I like to discuss with my patients at length at the consultation.
Hope this helps!

Hello Adventurous5183. Thank you for your question regarding the need for a vertical scar after your tummy tuck.

The vertical scar you mentioned is likely related to the relocation of your belly button. During a tummy tuck, especially when there is a need to reposition the belly button, the original location of the belly button is often closed with a vertical scar. This can be necessary even in thinner patients if the amount of skin removal or the extent of tightening required involves a significant portion of the upper abdomen.

In cases where the belly button needs to be moved, the vertical scar is created to close the area where the original belly button was located. This is a common practice and helps ensure that the overall contour of the abdomen is smooth and tight. Even in patients who are fit and have not experienced significant weight loss, the positioning of the belly button and the need to address any upper abdominal skin can result in the need for this vertical scar.

I hope this helps clarify why the vertical scar was necessary in your case. Good luck, and thank you for your question regarding the vertical scar after your tummy tuck.

Sincerely,
Dr. Katzen

Good question! In order to get the horizontal scar as low as possible, and because the aperture where the belly-button used to be will become a hole, a vertical scar is sometimes used to address that hole. Depending on how far the skin around the prior belly-button can move or reach, that determines the vertical scar length. People with a lot of laxity don’t need a vertical scar at all because that belly button hole can reach the horizontal scar

The only person who can answer that question is the one who created that scar, your surgeon. If you do not understand his/her/their explanation about why that scar came to be, ask again for the answer in terms you understand. We add short verticals in some patients to keep the horizontal low to accommodate sparing bikini styles. We minimize vertical scar length by extensive use of progressive tension sutures, operating table flexion, discontinuous undermining, and other measures. In agreement with Dr. Edelson, a year or longer after your initial procedure, it may be possible to shorten that scar.

A vertical scar is needed under two principal circumstances: one is that the skin is not only loose vertically but horizontally. So if the tummy tuck only pulls the skin down, the belly skin will still be loose when you move it side to side and may bunch up. This is particularly true after massive weight loss.
The other circumstance is when the patient has a tall torso and the lower incision is far from the belly button. In that case when the skin is pulled down, it will be too tight to close if there is no vertical component where the belly button used to be. I hope you got your answer.

A small vertical scar is done times necessary especially if you don’t have that much excess skin and the surgeon is trying to keep the scar low. After some time it may be possible to remove more skin and some of the vertical scar along with it

There are two common needs for a vertical scar. The first is when the belly button is in a higher position and there is not enough excess skin. The small vertical line represents the closing of the skin that was previously around the belly button. The second is when there is moderate to severe skin laxity in the middle upper abdomen. This incision pattern is called fleur de lis and is seen most commonly in those with significant weight loss. More information is needed to determine why your incision pattern is the way it is. I encourage you to speak to your surgeon about your concerns.

Vertical scars are used to remove excess vertical skin, especially in patients with massive weight loss. In massive weight loss, there is more vertical and upper excess skin than can be removed with the inferior incision. The vertical incision might also be used to repair a hernia. If you have questions about your scar, please ask your surgeon.

To make a quality assessment regarding the outcome of a plastic surgery procedure, we generally always need to see a complete set of proper before and after pictures.
Without seeing before, and after pictures, we can’t begin to make an assessment regarding your candidacy or the outcome of the procedure.
On individuals who don’t have a lot of vertical skin laxity it may be necessary to leave a small, vertical scar that represents the excision around the umbilicus. this is necessary in order to set the scar in a low position without putting undue tension on the abdominal skin.
Some people have a deep umbilicus and some have a bellybutton that is not deep.
Some people have a wide opening around their bellybutton, and some do not.
Some bellybuttons are easier to work with than others.
Some plastic surgeons are better at doing this procedure than others.
Being bored, certified in plastic surgery with years of experience, and an overall good reputation does not mean somebody has mastered any single procedure.
If you have concerns regarding the outcome of your procedure, I suggest you bring it up with your provider and ask him or her to review your concerns.
The ability to deliver, consistent quality, liposuction results various substantially between providers.
In the end, the surgeon is responsible for the outcome of the procedure and the patient is responsible for selecting that provider.
To find the right provider I generally suggest patients start the process by scheduling multiple in person, consultations with providers in their community who seem to have a strong Track record of doing a lot of these procedures preferably with overall good results.
It is important that patients begin to learn to recognize the difference between quality outcomes, and those that are not as good.
I generally judge tummy tuck results based on who gets the most natural looking bellybutton with a very low set scar that follows anatomic contours, naturally, and evenly on both sides.
in regards to incision design, I find that Dr. Eleonore Zetrenne MD produces incision designs that are some of the best I’ve seen.
Most likely inspired by her teacher Mark Kobayashi, MD.
You can take a look at her website to get an idea of what I think is ideal, scar designs.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patient who had similar body characteristics to your own.
An experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients for commonly performed procedures like a tummy tuck.
Being shown a handful of peace, selected images, representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done.
Take care notes during each consultation, especially regarding the quantity and quality of before and after pictures.
There’s no correct number of consultations needed to find the right provider.
The more consultations you have the more likely are to find the better provider.
Sometimes it’s simply a matter of luck.
Considering how much variation there is in among different providers I think having five or six consultations seems appropriate.
People will be reminded of the outcome of this permanent and irreversible procedure every day for the rest of their life.
The time to be critical of plastic surgeons is during the vetting process before you scheduled surgery .
I have no idea why your surgeon did what they did.
I’m sure they had their reasons or they wouldn’t have done it.
Talk to your provider and see what they have to say.
I’m guessing that they initially started with a short scar, but the skin contour did not close well, and left the appearance of “dog ears”.
The correct treatment of “dog ears” it to extend the incision and make it longer.
Sometimes it’s a balancing match between the length of the incision and the abdominal wall contour. Perhaps your surgeon thought that the necessary longer scar would simply look better if they connected the dots.
There may be some truth to this.
That said most of the time when a plastic surgeon can’t clear the bellybutton during a full tummy tuck, they typically leave that small vertical scar on the small side.
Best,
Mats Hagstrom, MD