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

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

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.

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.