Why Are Tummy Tuck Incisions So High?

I've been to 3 consultations and have looked at numerous pictures on the internet from all over and it seems as though the Tummy Tuck incision is very high.

It doesn't look like the scar will be concealed with a bathing suit bottom let alone underwear or when I'm wearing jeans. Especially where the incision curves up, is where it looks like it will be hard to hide unless you wear your bikini or panties high up like how they did in the 90s.

Why can't the incision be almost straight with little curvature and have it as low as where the pubic area starts?

Doctor Answers 19

Incisions for Tummy Tuck

There are several reasons why Tummy Tuck incisions end up high. First, the central point of the incision must be no more than 7-9cm above the commisure or top point of the vulva. The problem can occur if the pubic tissue isn't elevated as it would end up when the preopertive markings are made. Next, if there isn't enough tissue to be taken out then the hole that did house the belly button will not be taken out when the top incision is made leaving a vertical incision some place between the belly button and the pubis. Finally poor preoperative planning is usually the cause of most high incisions.

Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Tummy Tuck / Abdominoplasty Incisions

Before I perform an abdominoplasty, I mark the top line of the patient's undergarment or swimsuit to try and approximate the incision with the clothes they normally wear. The incision location is also dictated by the patients body and underlying muscles and bone structure. There is usually a cure to the incision to match the natural curvature of the body. I hope this is helpful. Good luck with your procedure

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Tummy tuck incisions

Your question is an excellent one-- I think you can get a very nice result with a low incision, and the key is to ask your surgeon in advance where he is planning on placing your incision. I usually ask patients how they normally wear their bathing suit or underwear, so that I can plan to place the incision in a way that it can be hidden. I think the trend is to place the incision lower and flatter, and you just need to make sure you and your surgeon are on the same page. Look at their before and after photos as well as this will give you a good idea of what you can expect for the final result.

Good luck,

Dr. S

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Picking the location of your Tummy Tuck scar - You CAN have it your way!

The location and shape of the Tummy Tuck (Abdominoplasty) scar in my opinion should be TOTALLY up to you. But - you need to understand what your choice would mean.

If your read between the lines (no pun intended...), there are several preferences for Tummy Tuck scars among Plastic surgeons.

The Geometrical approach - pick the belly button as the apex of a triangle - and base the height of the side scars on the length of an imaginary triangle with equal limbs - resulting in higher arching scars sideways.

The Customized Tailoring approach - The surgeon picks the transverse location of the scar based on your preferred style of underwear / lower bathing suit which YOU plan on wearing from now on. You decide how low the scar will be - we work with that as the limiting factor.

The advantage of doing it this way is the transverse scar is hidden even with low underwear. The disadvantage is than in women with NOT a lot of excess lower tummy skin, the former location of the belly button cannot be removed and results in a short vertical scar, often hidden by your clothes.

I prefer to let my patient choose the location of their scar. It empowers them, and they become an important part of the decision.

Summary - You SHOULD be able to pick the scar YOU WANT - not accept a scar you do not want.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Anchoring sutures

Thank you for your post. It is not common for surgeons to anchor the lower incision to the fascia or covering of the abdominal muscles to keep the scar low, however, I do use this technique and agree with it. All the tension on the incision is from above, not below, and thus the scar tends to move toward the area of maximal tension (towards the ribs/bellybutton). This moves the scar higher than desired. I like to keep my scars very low, and feel that anchoring the scar helps accomplish this. The following photo is an example of this.

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Placement of tummy tuck incision

There are many different types of tummy tuck incisions, depending on patient anatomy and desires, but the incision you speak of is the one most plastic surgeons generally use. It is an extension of the bikini (Pfanensteil) incisions that obstetricians use in C sections. Unless you wear a string bikini or a brief thong it will be covered.

Barry H. Dolich, MD (Retired)
Bronx Plastic Surgeon
4.0 out of 5 stars 1 review

I don't understand why it can't

There are any number of variations on scar placement. When I do the tt, I have the patient wear panties or a bathing suit so that I can hide the scar.

Some considerations however include shape of the pelvis, position of the umbilicus, and amount of panniculus to be removed, as well as your body configuration.

Check out some of my photos and you will see all body types can have a nice outcome.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Tummy tuck incisions, high vs. low

It is possible to make lower incisions with full tummy tucks, but then the patient usually gets a vertical scar, typically just above the main incision itself. The scar itself can be placed in any of many patterns, depending on the patient's wishes.

The reason for this is that when a full tummy tuck is done, lots of skin and fat are removed, from above the belly button (this enables tightening of the upper abdominal skin) as far down as the surgeon can go. There comes a point where you just can't take more off. The final incision then becomes an "average" of the upper incision and the lower incision. In patients with a lot of loose skin, ironically, the incision can be lower than with ladies with very little loose skin.

The low incision is a good compromise for many patients. They can then wear lower jeans, but do have to contend with a small vertical scar. For many patients, that is a welcome option.

In some respects, having more choices increases the complexity of the decisions to be made. However, it is actually refreshing that women nowadays have many more options than just the mini or the full tummy tuck.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Why Are Tummy Tuck Incisions So High?

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. Thank you again for the good question.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Tummy Tuck Scars

A low incision can give you the result you want, Ask your surgeon what type of incision you need to get beforehand to see what results you can expect from the procedure.

Jonathan Fisher, MD
Miami Plastic Surgeon
4.3 out of 5 stars 1,095 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.