Whats the Reason for a Tummy Tuck Needing to End at the Belly Button? (photo)

Im sure this gets asked a lot but I couldnt find a direct answer. I understand that tummy tucks do not go higher than the belly button, but i was wondering why exactly? Is there a medical reason for this or is it just to gain a lower scar that is able to be hidden? My stretch marks go very high, but if I opt to have a higher scar, will a surgeon go above my belly button? I would cover a high incision scar with tattoos which would be much easier then to try and tattoo over stretch marks.Thanks

Doctor Answers 8

Tummy tuck scar location

Usually people want their final tummy tuck scar to be low enough where it is covered by a bikini and that limits how high or how much of the strech marks can be removed above the belly button.  If your ok with the final location of your tummy tuck scar to be high where it is not covered by a bikini and would rather have all of the strech marks removed then it can be done.  Please make sure when picking your plastic surgeon to look at the before/after photos and make sure they show you at least 20 patient's photos and show you at least 6 views from each patient including the sitting views.  Good luck

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 60 reviews

Level of Skin Excision and Location of Tummy Tuck Scar

Your supposition is a correct one. The higher the upper level of excision in a tummy tuck, the higher the final scar would be. It is all about trade-offs. Tne more skin and stretch marks are removed above the belly button, the higher the scar will be. If less skin and stretch marks are removed, the scar can be lower. You have to decide which is a better aesthetic choice. The vast majority of women would prefer a low more 'hidden' scar with residual deformed skin.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Tummy tuck goal is maximum stretch mark removal, low incision line, and no vertical scar.

You are correct that usually we don't cut much higher than the belly button so we can keep the final scar as low as possible.  You are also correct that this incision could be made a few inches above your belly button if you did not care about having your final lower abdominal scar riding high, above your panty line.  Personally, I find this not a great option.  It is possible to go a little above the belly button and still wind up with a scar hidden within the panty line by flexing the operating table and using anchoring sutures during surgery (these are tricks experienced plastic surgeons use to keep the scar low).  Patients are stooped over after surgery and it can take a couple weeks for them to stand up straight but they don't mind if this means a hidden scar.  In your case, you would still have a few stretch marks just above your pubic area but this is not usually a big problem.  You could wear a little concealing makeup if you want and you could still get a tattooo if necessary to hide persistent stretch marks.  I've attached a link to my website.  There are some women with abdomens very similar to yours you might want to check out.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 56 reviews

Tummy scar can be higher to allow excision of more stretch marks

This is an excellent question and one that I have never come across before!  You are exactly right.  Typically, both the surgeon and the patient want the scar to fall underneath the bikini line, so that if wearing a bikini bottom or underwear, the scar will be hidden.  Of course, this means the scar is pretty low.  The surgeon will usually cut just above the belly button and remove the skin between this incision and the incision in the bikini area.  The skin above the upper cut will then slide down to the lower incision and the skin is closed, resulting in a scar in the bikini area.  The reason why the upper incision is not made higher, which would allow removal of more stretch marks in your case, is because too much skin would be removed and it would be hard to close the incision.  However, as you VERY accurately pointed out, if you will accept a higher location of the bikini scar, then the surgeon can make the upper incision higher, thus excising more skin above the belly button.  We actually do this sometimes for TRAM operations to reconstruct the breast after mastectomy.  When doing a TRAM sometimes we need the skin above the belly button and we do exactly what you described.  So the short answer is yes, it can be done.  Hope this helps.

Tracy Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Tummy Tuck Scar Position

In an abdominoplasty, or tummy tuck, the skin is elevated off the muscle up to the umbilicus for a mini, and up to the ribcage for a full tummy tuck.  The skin is then pulled down and the excess cut off.  Normally, the surgeon is able to remove most of the skin from the mons to the belly button.  The skin above what is cut off then is stretched down to the lower incision at the mons for closure.  If you try to remove more of the upper abdominal skin, you won't be able to close the wound.  For women who have stretch marks below the umbilicus, this works well to remove them.  For those with stretch marks in the upper abdomen, they will be pulled tighter, but there really is no way to cut them all out.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Scar and tummy tuck

I remove as much skin as I can, depending on how much there is. SOmetimes I can remove some of the skin above the belly button, but it depends on your specific situation, how much looseness, or elasticity there is. Where to plan the scar is a discussion best done with your surgeon in advance. Best of luck!

Victor Au, MD (retired)
Chapel Hill Plastic Surgeon
4.5 out of 5 stars 7 reviews

Hidden tummy tuck incision, stretch marks

Hello Dreamin

Tummy tucks have been categorized by our Brazilian colleagues as fitting into 9 categories.  Ranging from liposuction alone with a small excision to a full tummy tuck that extends from the bikini line to the bottom of the ribs in addition to liposuction.

If there is not enough skin laxity to stretch the abdominal skin you may not be a candidate for a full tummy tuck.  In that case a partial tummy tuck with downward floating of the belly button could give you improvement and tightening of the skin above the belly button while still keeping the scar low.

Low scars are preferable as they are easier to conceal.

Please have a local Board Certified Plastic Surgeon evaluate you in person to determine which procedure would be best for you. Cheers

Luis A. Cenedese, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 19 reviews

Tummy Tuck Needing to End at the Belly Button?

While a mini-TT does not go above the navel, a full TT reaches up to the breast bone and covers the entire abdomen. It adds an incision around the navel to the low abdominal incision. It is hard to tell from the photo alone, but as a rule, the skin that will come out is from the navel to the lower abd incision, and the upper skin will stretch down to reach the lower incision. Stretch marks above the navel will be lower down, but not gone. 

The usual strategy for the main incision is for it to be hidden by swimsuit and underwear. There are occasions that call for an alternate incision, but that would need to be discussed at  a consultation.

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.


Thank you for your question, best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.