Should I Get a Secomd Opinion About Small Vertical Incision with Full Tummy Tuck? (Photo)

I had my first consultation with a highly acredited plastic surgeon whom I have admiried for quite some time, I was very pleased to hear he could and would be able to make my horizontal TT scar as low as my cesarean scar. Although, he tells me that my torso is rather long and my belly button sits high and he would not only have to make a horizontal scar but a small vertical scar. He also stated the scar would be small and would still be hidden below my bikini line. Is this common?

Doctor Answers 17

Tummy tuck and vertical scar

When you look on the internet at pictures of women who have had a tummy tuck you'll see a lot of results that, at first glance, look just great.  But, when you take a few minutes and really evaluate the results, you'll notice a few things. For instance, most plastic surgeons make the transverse incision low on the abdomen.  However, in many of the pictures what you'll see is that some of the final transverse scars are higher than in others.  Coupled with that, the pubic hair in those patients is pulled up a bit too high, looking like it's now half-way up to the belly button.  When that happens it's usually because the surgeon could possibly have placed the incision lower but was concerned that the patient would end up with the small vertical scar, so the surgeon made the incision just a bit higher to avoid that vertical scar.  I'm a believer that the pubic hair needs to stay where the pubic hair belongs.  I tend to make the incisions low, but that means that women with findings like yours many times will end up with a vertical scar in the midline just above the transverse scar.  If you have any doubts, you absolutely should obtain at least one more opinion, maybe even more than one.  Ultimately you need to make sure that you and the surgeon you choose are on the same page regarding your desires and expected outcome. 

Fort Worth Plastic Surgeon
4.9 out of 5 stars 30 reviews

Tummy Tuck with Small Vertical Scar

Your surgeon is is correct. With a high belly button and low incision (scar), a short vertical scar may result. These tend to heal very well after a few weeks. Most patients prefer a lower scar than a higher scar. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Tummy tuck scars

I personally prefer to try to avoid the vertical scar because it doesn't always heal as well as a horizontal one.  Nor is it always hidden by a bikini. Consequently I stay with the horizontal and go as low as I can.  Just my preference.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Second opinion and Tummy Tuck

Great question. Given the position of your belly button, I agree with your surgeon you may need a vertical incision. The other options available would be to place the tummy tuck incision higher and more visible on the abdomen or to float the belly button and lower it quite a bit. Either option is not very good compared to the vertical scar.

Lisa M. DiFrancesco, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 34 reviews

Should I Get a Second Opinion About Small Vertical Incision with Full Tummy Tuck?

From the looks of the photo, I concur with your surgeon, and would not get a second opinion on that basis alone. This is a common occurrence in patients with your particular anatomy.  Some might offer no vertical incision, but a higher TT scar, which means the whole incision is higher, and that makes no sense to me. Other possibility is lowering the navel, but in my experience, most patients feel the new navel position is "wrong" even when the surgeon feels it is better. 

Often, after a year, there is enough relaxation that the vertical incision can be removed in a minor touch up procedure. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Small Vertical Incision with Full Tummy Tuck?

Thank you for the question.

Sometimes, especially for patients with a relatively short torso and/or minimal redundant abdominal wall skin, a short vertical scar is necessary ( in addition to the usual transverse tummy tuck scar). This vertical scar results from closure of the previous umbilical opening and prevents excessive tension upon closer in the midline of the tummy tuck incision line. If this vertical incision is not used, patients may end up with wound healing problems and much wider scars. Sometimes these vertical scars can be revised/ removed ( usually one year or more after the tummy tuck surgery).   I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Should I Get a Second Opinion About Small Vertical Incision with Full Tummy Tuck?

In my opinion you can have a good result from a tummy tuck without a vertical incision and it should be low enough below your bikini line. See a board certified Plastic Surgeon for consultation or another opinion.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
4.7 out of 5 stars 12 reviews

Should I Get a Secomd Opinion About Small Vertical Incision with Full Tummy Tuck? (Photo)

You're getting many second (and third and fourth..) opinions here, and I'm in agreement with all of them.  Your surgeon is absolutely right, but I also agree with responder(s) who state the lower abdominal vertical component may or may not be hidden behind bikini bottom... Who cares, your belly should look so much better, and if the scar is low and of poor quality, it can be revised.  If the horizontal scar is higher, you won't ever want to wear a bikini.  Go for the lower scar with the vertical component.  Alternatives include a small horizontal scar where the belly button was in the lower abdomen, a mini-tummy tuck with or without liposuction, or "floating" the umbilicus (belly button) with the abdominoplasty flap.  Your body looks trim, maybe an aggressive mini-tummy tuck is all you need. 

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 47 reviews

TT and vertical scar

Looking at your picture, I would agree.  The problem is that you have a highly placed navel, and if all of the skin is removed between it and the C-section scar, a severe wound complication would likely result due to tension.

I wouldn't be able to promise that the vertical scar would be completely hidden however.

If you have doubts, you should always seek another opinion

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.8 out of 5 stars 106 reviews

Should I Get a Secomd Opinion

I tell all my TT patients that have the anatomy you describe they may have that small vertical scar. But since I began using the progressive advancement technique a few years ago I have found that vertical scar is rarely necessary. Make sure your surgeon has experience in that technique and be confident that you will only get the vertical scar if there is no other option.

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