What are my chances of having a nice smiley cut/scar after a Tummy Tuck?

I am considering a TT the only thing i am worried about it that my scar is going to be unequal, not like a smiley. I've been looking at TT after pics and seems that almost all have an unequal scar like it is not a nice line, like a smiley and some even are like totally horrible. What are Doctors guidelines and what does it depend on to have a nice scar. What can a doctor do to almost guarantee a nice smiley scar?

Doctor Answers 10

What are my chances of having a nice smiley cut/scar after a Tummy Tuck?

Thank you for the good question. There are many factors involved when it comes to the exact "scarring" you see on different photographs. Sometimes, there is a difference because every plastic surgeon may have a different approach to placement of incision lines and exactly how the operation is performed. On the other hand, scars may differ because of different patient body types and because patients scar differently. Again, there are many variables involved.

My best suggestion: select your plastic surgeon carefully. Make sure that he/she is a board-certified plastic surgeon who can demonstrate significant experience achieving the types of outcomes you will be pleased with. Before/after photographs are helpful in this regard. You may also be able to meet/see/talk to previous patients who have had surgery with your plastic surgeon. Then, communicate your concerns/personal goals carefully as well. 

I find that marking patients the day before surgery, as much as possible, with the help of the patient's planned swimming suit or undergarment, helps when it comes to placement of incisions…

You may find the attached link, dedicated to tummy tuck surgery concerns, helpful to you as you learn more.  Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Tummy Tuck Scar

Tummy tuck incisions/scars are very carefully drawn out pre-operatively in order to insure optimal shape and symmetry. This is usually done in the holding room just prior to surgery.  However, it is rare to see a patient who is perfectly symmetrical in the lower abdomen when measuring bony and skin surface landmarks.  Additionally, skin tension across the scar and other healing forces are rarely equal side to side. So, many factors can contribute to scar shape as well as symmetry.  It is critical that you discuss this concern with your plastic surgeon before the day of surgery so he/she can give you an analysis of your abdomen that includes an evaluation of side to side symmetry in the lower abdomen where the scar will be placed as well as a discussion of the shape of the scar after surgery.

Robert C. Bledsoe, Jr., MD
Grapevine Plastic Surgeon
4.0 out of 5 stars 4 reviews

Tummy tuck scar

Most plastic surgeons try to make our scars equal and symmetric especially when we cross a midline. Unfortunately, no 2 sides are the same and their may be asymmetries when it comes to the soft tissues and skin. Stretch marks and skin laxity also play a role. Talk to your plastic surgeons and discuss your concerns in detail.

Kiran Polavarapu, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 40 reviews

What are my chances of having a nice smiley scar after a TT?

I think its important to listen to patient's requests carefully and try to deliver within reason. In the case of scar placement during a TT, a surgeon may mark and cut exactly where you would want only to have it stretched out of place due to tension or hidden asymmetries within the tissues. I used to perform the classic "W" pattern incision on my TT's, but have moved away from that after much dissatisfaction and complaints from patients. I now perform the "smiley" pattern and agree is much more appealing esthetically than the old "W" pattern. I am grateful to patients like yourself that are not shy about expressing what they want. 

Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

What are my chances of having a nice smiley cut/scar after a Tummy Tuck?

Remember that no two sides of the body are exactly symmetric so the scar will never be perfectly symmetrical but it should be relatively close. I plan the TT scar to be as low as possible but obviously, there are anatomy considerations that also play a part. Also, every patient's wound healing response is slightly different so this can also affect the final appearance. Most plastic surgeons close wounds in multiple layers to help reduce tension on the skin so the scar doesn't widen. Also, patients can use scar treatment gels/creams to help with scar appearance. Best to look at the pictures provided by your plastic surgeon and see if you'd be interested in getting a similar result. Good luck!

Farah Naz Khan, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 100 reviews

What are my chances of having a nice smiley cut/scar after a Tummy Tuck?

Your concern is reasonable but it is important to understand that in the human body the two sides are never a perfect match. But they should be close. Like you, I am amazed at some of the odd scars I see on TT patients. It is most important to choose an experienced and artistic surgeon and examine the doctor's postop photos to get an idea of how low the scars routinely are placed as well as their shape and evenness. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Reducing the prominence of a tummy tuck scar?

Many factors are involved in the success or prominence of healing a tummy tuck scar.  It is incumbent on the surgeon to make the sides of the incision as symmetric as possible but do recall that most patients bodies are asymmetric and there may be different amounts of skin to be removed on one side versus the other.  Secondly, genetics and quality of healing are somewhat unpredictable and an important determinant of the eventual outcome.  Third remember that all scars become prominent at about 3 to 4 months after surgery and take anywhere from 9 to 15 months to fade to the degree that is possible.  Another very important factor is for the surgeon to avoid making the incision too high if you do not have adequate skin laxity to allow the circle that surrounded your belly button to reach below the pubic incision.  Some of the worst scars that I have seen were made too high either pulling up the pubic area or getting too close to the belly button leaving a very visible transition between abdominal skin and suprapubic skin that can never be corrected.  During the initial healing phase I have had success with use of Embrace Scar Therapy which uses the application of tension reducing tapes to take the tension off the incision for a period of approximately eight weeks.  This does not guarantee the quality of healing or creates a necessarily invisible scar, but does help to diminish prominence.

The most important thing in my opinion is for you to be realistic about the outcome of your surgery and benefits of undergoing it.  The trade-off for most patients is very worthwhile in undergoing this procedure.  Best wishes and good luck in your healing,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Tummy tuck incision

Hello and thank you for your question. The first and most important thing to understand is that NO ONE can GARANTEE anything in cosmetic surgery so if anyone does guarantee something I would be weary. I understand that the length and appearance of the tummy tuck scar can sometimes be a little worrisome. But the result of the scar depends on many different factors. One factor is tension on the incision. The more skin and fat removed from the abdominoplasty, the flatter the abdomen will be but then the more tension on the wound there will be. There are things done during the suturing process that can help limit the tension on the incision. The incision should be closed in multiple layers. Another factor maybe the patient themselves. Everyone heals differently. You can do the same operation, exactly the same way, on 2 different people and they can have different results because they just heal differently. After surgery there are some things you can do for scar care to also help with the incision. Remember also, that as human beings, we are ALL asymmetric by nature. This means, that as plastic surgeons, as much as we try and get things to be as perfect and symmetrical as possible (like the appearance of a scar) it is almost impossible to achieve perfect symmetry. I hope this helps and good luck! Hopefully you are being evaluated by a board certified plastic surgeon.

Ankur Mehta MD

Ankur Mehta, MD
Sugar Land Plastic Surgeon
5.0 out of 5 stars 17 reviews

Scar should end up as a thin line

Thanks for your question. The scar on an abdominoplasty can be daunting to see at the beginning. Fortunately however it heals from top to bottom and not side-side. As long as there is not tension on it the scar should heal nicely and the color will fade away. Scar treatment like Silagen has been a good adjunct as well but good surgical technique is the most important. Those who are prone to poor healing and thus bad scars are those who are obese (BMI over 30), smokers and diabetics. Previous surgical scars and overall body habitus are also things that are taken under consideration. Find a Board Certified Plastic Surgeon in your area that is an ASAPS member and specializes in cosmetic body contouring. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 90 reviews

Scar Appearance Post Tummy Tuck


Thank you for your question. Your scar placement and appearance will depend on your existing anatomy and your Plastic Surgeon's technique. I recommend that you seek board certified Plastic Surgeon's in your area who specialize in this procedure and who can show you before and after photos which appeal to you. Talk about your aesthetic goals and concerns at your consultation. Your surgeon will examine you and let you know which approach they feel can give you the best result.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 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.