49kg, 5'1, could I be left with uneven bulges if I have a TT with shorter scar? (Photos)

Dear foozball,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hi, thank you for sharing your question. You may be a better candidate for a full tummy tuck rather than one that limits the scar which may compromise the amount of skin resection and leave “dog ears”.

Based on the location of the fold of skin in your lower abdomen your scar would need to start and end where the fold begins and ends. Based on your specific anatomy it looks as though your scar would likely be slightly shorter than you see in abdominoplasties. The loose skin in your upper abdomen would be corrected as it is pulled down and excised. Your hips and lateral abdominal walls can be thinned with liposuction. While your scar will be shorter than many abdominoplasty incisions it will be present and you have to be prepared to trade what you have now for a scar. It is a good idea to have an additional in office preoperative meeting with your surgeon to make sure you were both very clear on the plan.

I would never consider less than a hip to hip incision for this presentation. You are trying to tighten the entire anterior abdomen. You need a hinge point, so you can lift up the entire width and pull it down and distribute the excess. Like a visor with a hinge laterally, the abdominal skin needs a hinge at the point where the front transitions from front to back, at the lateral midline or anterior axillary fold.
There may be situations where a slightly limited incision is appropriate, but in my opinion, this isn't one of them.

Hello ,
Thank you for your question.
Your concern is valid. While a "full tummy tuck with a shorter scar" (sometimes referred to as a modified or short-scar abdominoplasty) can be effective in removing vertical laxity and tightening the upper and lower abdomen, it may not adequately address horizontal skin laxity or loose skin/fat extending toward the flanks or hip creases. This can result in residual bulging or puckering at the lateral abdomen if not carefully planned. At your low BMI and petite frame, precision is key — and over-promising with a "shorter scar" may compromise the result if it limits skin excision. Be sure your surgeon evaluates the extent of lateral laxity and discusses whether liposuction or extending the incision slightly may yield a smoother, more balanced outcome. It’s better to have a well-placed, slightly longer scar than a shorter one with contour issues.

Your surgeon very correctly has indicated a full tummy tuck or abdominoplasty; he aims to pull the entire anterior abdominal skin and, I expect, to treat the evident severe diastasis recti you suffer (the abdominal bulge due to linea alba weakness / widening).

However, be wary of and stay very very far from miraculous short scars in tummy tucks, all of them, systematically all, end with ear dogs at the hips (lumpy skin redundances) and other problems. Scar has to be as long as needed to obtain a smooth contour and perfect adaptation around the body.

Another comment: you have abnormally high belly button location, not that rare to find in abdominoplasties; this precludes the inclusion of the original belly button exit hole through the abdominal skin within the portion of skin that's removed and discarded, hence the hole has to be closed in a linear fashion leavin a 1-2 inches vertical scar next to the horizontal one. This particularity is inevitable, do discuss it with your surgeon; any forced maneuver to avoid this short vertical scar leads to necrosis due to over-tension closure or pubical hair/mound raise into the abdomen and vulvar distortion.

You are a candidate for a full (conventional) tummy tuck in order to remove all the excess skin on your abdomen, achieve a flat stomach, and create a more balanced silhouette.

You are very perceptive in that when considering a shorter scar for an abdominoplasty or tummy tuck operation, this may leave leftover loose skin on the sides. The reason is that the skin and fat that is removed between the umbilicus and the pubic area is elliptical or roughly football-shaped where the most skin is excised from the midline (along the belly button area) and tapered toward the sides or hips. In an attempt to keep the horizontal scar as short as possible, there may be excess skin that, when sutured, "heaps" up causing a bulge or what is called in the business a "dog ear". It is not uncommon to do a small dog ear excision a few months later if it doesn't settle in which is a small compromise in that the horizontal length of the incision can be kept shorter. Of course, that varies with how much skin has to be taken in, the size of the patient, etc. but you hit the nail on the head as far as the concept goes. Other considerations are how low to place the scar; in my opinion, the lower the scar is placed safely, the more it can be hidden below the waistband of a reasonably sized two piece swimsuit or lingerie.

Hello and thank you for your question.
Based on your photos, you appear to have extra/loose skin above and below the belly button, along with some degree of muscle separation (diastasis). A tummy tuck would certainly offer you a transformation. Every surgeon has a different technique and set of criteria they evaluate in making their surgical decision. In my hands, a patient with loose skin above and below the belly button, with diastasis and with a high riding belly button is likely a good candidate for a full tummy tuck (incision from hip to hip) with muscle tightening, and I counsel them that there may be a small vertical incision at top midline of the horizontal incision, due to the native belly button being high and our goal of removing all of the skin between the belly button and the pubic incision. Your next best step is to seek another opinion from a board certified plastic surgeon with an in person examination. You need to be comfortable with the surgeon and the plan.

Thank you and good luck on your journey!

It looks like most of the skin laxity is central in your photos, so keeping the incision shorter than a fully tummy tuck actually might work in your favor here. The real difference is the degree of dissection and how much of a change you hope to see above the belly button. It sounds like your surgeon is suggesting what some of us might call an "extended mini TT." Small contour irregularities are always a risk after liposuction and/or body contouring surgery but from what I can tell this is not a bad plan.

Thank you for submitting your questions and photos. Based on your photos, you would be an excellent candidate for a full tummy tuck. This would address the loose skin above the belly button more than a mini-tuck would be able to do. The length of the tummy tuck scar is a little different for each patient based on their anatomy. You appear to hold more weight and skin laxity towards the middle. Therefore, your full tummy tuck scar wouldn’t necessarily need to go all the way from hip to hip. Your surgeon should be able to show you the length of scar to expect. You may require diastasis repair to help flatten the tummy, and possibly liposuction to the upper abdomen and waist for contouring. Your surgeon can explain this in further detail. Good luck and thanks again for reaching out.