Is a vertical cut below the belly button the best technique? (Photos)

Question

Dr.’s have advised 2 options regarding my Bellybutton during a mini TT. Opt 1: pull down excess skin, cut a new hole for my BB and then sew up the old hole, causing the vertical scar. Opt 2: pull the skin down and then cut off the excess skin that will form at the top of the BB. My Q is this, Is the vertical cut/new BB hole necessary or can you achieve the same results with opt 2, thus not creating the extra scar? (Also, I have mesh from prior BB hernia repair)

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding a vertical cut below the belly button is the best technique for removing excess skin. Thank you for this most interesting question. There are basically two techniques to get rid of your excess abdominal skin. Both techniques would involve a horizontal excision to get rid of your excess abdominal skin. I do not think it's worth doing a vertical tummy tuck to eliminate your excess skin because the incision would extend above your belly button, which would not be aesthetically pleasing. Therefore, your best solution would be a horizontal excision for your tummy tuck. The question is where to place this horizontal incision, precisely, whether it should be placed high or low. If the incision is placed so the incision can be hidden underneath your underwear pant line, then the area of skin from the incision to the top of your belly button will not be eliminated. With this technique, an incision would be made around your belly button hole will be closed. The second technique places the incision higher and maybe above your underwear line. With this technique, the skin and fat from the incision line to the belly button would undoubtedly be removed and there would be no need for a vertical belly button scar. However, the giant horizontal scar may be under your underwear line and be less visible. The trade-offs are a low incision with a vertical belly button scar or a higher incision, perhaps more visible without a vertical belly button scar. I would opt for option 1 with a lower incision and a vertical scar where your belly button has previously been. In my opinion, this would be the best aesthetically pleasing look. I hope I've helped to answer your question regarding a vertical cut below the belly button is the best technique for getting rid of excess skin. 
Sincerely,
Dr. Katzen

Joel Patrick Maier, MD · Answer

Given the fact that your muscles are tight without obvious diastasis, I would recommend a skin only tummy tuck option. As is always considered in the discussion, there may be a vertical scar extending from your low horizontal scar where the umbilical hole does not stretch all the way down to the horizontal scar. That may be the trade-off for maximum tightening of the tummy skin and making for a tighter, cleaner belly button with no hooding of skin over the top. An in-person consultation with an experienced body plastic surgeon will help in decision making. See attached case for reference. Thank you.

Gary M. Horndeski, MD · Answer

A vertical cut below the belly button is not the best technique.  You have enough skin, particularly above the belly button, to most likely go with the 2nd option where there is no vertical cut.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Lindaw.,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

What you are describing is a standard tummy tuck, not a mini.  In a mini tuck the skin excised is below the belly button so there is no hole around it.  What you described is a new hole being created and the small vertical scar would represent the old belly button.  This is typically preferred in order to keep the long incision low.

Is a vertical cut below the belly button the best technique? (Photos)

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Is a vertical cut below the belly button the best technique? (Photos)

Answers (10)

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Everything you need to know about Mini Tummy Tuck

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