Tummy Tuck - Fake Looking Stomach?

There are many slight variations on how tummy tucks can be done and how the incision is placed. We always try to keep the scar as low and as hidden as possible. However each patient is different and these differences have a certain impact on the final result. You should look at a lot of before/after pictures before choosing your board certified plastic surgeon. Find one who's technique you like
Sincerely

Martin Jugenburg, MD

I am curious about what pictures you are looking at seeing high incisions.  In most cases the incisions are at the same level if not lower than a c-section incision.  The length of the incision depends on the amount of loose skin and, at minimum, the horizontal incision is about three times as long as the distance between your pubis and your belly button.  Tummy tuck or abdominoplasty removes extra skin and tighten the underlying muscles.  It does not add muscle definition - that involves exercise on your part.  If you post some "before" pictures of yourself, we may be able to give you some advice on what results you can expect.

 

Good Luck.

Some results from tummy tucks can be very beautiful. Other results may show an improvement, but may look unnatural or unattractive.  The ideal tummy tuck will leave a woman with a smaller waist and no scars around the belly button. Look at many, many before and after photos. Select a plastic surgeon who provides beautiful, natural results.

The incision is based on how much extra skin you have.The tightness or fake appearance will go away after the tissues have had a chance to relax and the swelling goes down.

Here are my suggestions.  You and your surgeon can control the position of the scar.  Bring in a pair of underwear panties and the surgeon will outline them.  Then he/she can draw the position of the scar so that it will fall within these pantyline.  In this way you can see where the scar would be.  Second, I totally agree with you that sometimes the abdomen looks "fake" afterwards.  That is because the natural curves and valleys of the abdomen are obliterated.  If the surgeon performs liposuction in the upper abdomen for contouring, this wll help achieve the natural curves of the abdomen.  If they don't want to do that, they can place a gauze roll in the upper abdomen and tape it in place for 1 week.  This will also help create curves.  The other thing that is very important is to remove some of the fat underneath where the belly button will be inset.  This makes a big difference.  Third, how the belly button looks makes a big difference.  There are little ways to improve this appearance as well.  So yes there are things that can be done.  My best advice to you:  meet with several plastic surgeons and look at many before and after photos.  When you find someone whose pictures match your aesthetic sense, that is probably the right surgeon for you.

Tracy M. Pfeifer, MD

Incisional placement in abdominoplasty is individualized per patient given the specifics of their anatomy and any previous incisions.  An attempt is always made to provide the most natural unoperated appearance. There are many anatomic relationships that can contribute to an unnatural appearance postoperatively.  In my practice, I find it is most important to make certain that the umbilicus or belly button is natural in shape and position, and that a waist is created in an appropriate relationship to the hip bones. In addition, between the umbilicus and the mons there should be a gentle curve rather than an overly tight segment of skin. Make sure that you review your concerns with your board certified plastic surgeon.

There are many factors that affect the placement and final position of a tummy tuck scar. While it is ideal to have the scar very low, that is not possible for many patients based on their anatomy and the amount of excess abdominal skin. Many full tummy tucks will end up with a scar that ends up higher than ideal due to the larger amount of skin removed. Mini- or partial tummy tucks always end up with the lowest scar but they also remove less skin which is why they can end up so low. Having a tummy tuck is about accepting the trade-offs of a scar and a tighter (which you refer to as unnatural) and flatter abdominal area versus the more natural look of of excess skin and fat with stretch marks. The outline of the abdominal muscles can never be created by a tummy tuck.

Viewing photos on just this site alone, the results from tummy tuck are no less than spectacular. Yes the scar is a trade-off, however the improvement in abdominal tone and contour has been transforming for so many. Fake looking, certainly not. It is the reality of the 'before' pictures which we find unsettling. The scar is kept low along the C-section line where is can be concealed. Beauty is in the eye of the beholder.
Best of luck,
peterejohnsonmd

Your perceptions may be due to the specific patients you viewed. Abdominoplasty scars are placed as low as possible centrally, usually just at or below the top of the pubic hair line. Laterally, they go wherever the patient wishes, depending on the most revealing garment they wish to wear. Someone wishing to wear a Bikini would have a low lateral scar. Someone wishing to wear a French Cut swimsuit would have a higher lateral scar. Whether the abdominal muscles are definable postoperatively depends on how much fat was present in the abdomen preoperatively and the state of the muscles. Because of blood supply concerns, it in frequently impossible to thin the entire abdominal flap enough to reveal the underlying muscle. Additionally, most people having an abdominoplasty will not have a well formed muscle definition.
 

The ultimate result from a tummy tuck procedure is primarily dependent on the patients original presenting size, shape, and body fat condition.  All surgeons tighten muscles, remove fat, and excise skin.  The placement of incisions can be somewhat elective.  However, look at photos of pre and post -operative results in order to get an idea of your special condition.  Meeting patients realistic expectations is critical to patient satisfaction.