Dear River, Your situation raises an important question regarding the necessity of a T-incision for your tummy tuck procedure. A T-incision, often associated with a fleur-de-lis tummy tuck, is typically recommended for individuals who have undergone significant weight loss and have considerable amounts of both vertical and horizontal excess skin. This method can be quite effective for sculpting and defining the abdominal area more extensively than a traditional abdominoplasty, which primarily addresses horizontal excess skin. Given your description as being in good shape with an hourglass figure, it's essential to clarify with your surgeon whether the T-incision recommendation aims to address excess skin and fat above the belly button in a manner that a standard tummy tuck might not. It's somewhat uncommon for patients who do not have a significant history of massive weight loss to require a fleur-de-lis abdominoplasty, but each case is unique. It's crucial to understand the rationale behind your surgeon's recommendation, as a T-incision or fleur-de-lis abdominoplasty introduces a vertical scar, which some patients might find less desirable. I encourage you to seek additional opinions from other board-certified plastic surgeons. This will provide you with a broader perspective on the most appropriate procedure for your specific anatomical needs and aesthetic goals. In many instances, my patients achieve excellent results with a full or extended tummy tuck, avoiding the need for a vertical scar while still obtaining a flat and contoured abdomen. Consulting with multiple surgeons will help ensure that the approach you choose aligns with your expectations and desired outcome. Please feel free to reach out for further discussion or clarification on your options. Your satisfaction and understanding of the recommended surgical plan are paramount. Sincerely, Dr. Katzen, Plastic Surgeon