Is the Shape of my Tummy Tuck Incision Normal?

In rare cases, sometimes the vertical incision is employed.  This is usually done because there was a pre-existing condition requiring a vertical incision and a scar was there originally, or there is so much lateral lax skin the surgeon felt the only way to pull that much skin tight was that approach.

The incision and resulting scar looks to be a Regnault or W type.  It is argued to have properties to take tension off the center of the wound, and provide good vascularization where it is most needed.  The soft tissue is stretched in the abdominoplasty operation, with the most stretch in the center.  Various incisions have been devised over the years to attempt to give the best results.  This would be seen by most as an incision type well known to plastic surgeons.  Best to discuss any questions you have with your surgeon.

Tummy tuck scar placement and design needs to be discussed with the patient prior to surgery so you won't end up with surprises. The incision you have is a Regnault or W incision, more popular in the 70's. If you are very tight, this gets accentuated if the pubic area is not fixed to the pubic bone. Usually when the pubic area advances upward due to increased tension, it creates a gentle curve, not as sharp as yours. I do not use this incision, because it is unnatural and brings pubic hair whereit does' t belong. I personally keep my suprapubic incision low (6cm from the confluence of the labia majora superiorly) and laterally carry the incision toward the pelvic bone. In the last few years, our incisions tend to be lower to bring it in lign with the current fashion.

Your tummy tuck scar has a more classical "W" shape that is one option and is entirely normal. During surgery the skin around your navel was stretched downward as far as possible. For patients with less laxity, the skin will not stretch down as far as it can with others. The options are to have a peaked middle part of the scar like you have, move the entire scar up to the level of the peak or keep the scar low and have a short vertical scar in the mid-line to close the transposed umbilical "donor" site. In many cases it is possible to discuss this plan in advance but in the OR the plans occasionally need to change to achieve a safe closure of your incisions. Many of my patients would prefer to have the entire scar lower and horizontal even if this means having a vertical scar in the lower abdomen.

Your shape is excellent and once your scar matures you should be very satisfied with your outcome.

Dr. Mosher

The use of a W-type scar in a tummy tuck is to improve the likelihood of wound healing. If too much tension is placed on the incision, it is common to see breakdown of the wound and worsening of the scar appearance. By leaving slightly more skin, this design is thought to lessen these risks. It appears that in your case, you had a previous midline incision from another surgery. This previous scar puts you at higher risk of wound healing complications and therefore using the W-type closure is a good way to mitigate some of this risk.