Vertical Incision Abdominoplasty

I would like to know if anyone ever had abdominal skin reduction with and up and down incision using () from 1 side of the abdomen to the other side of the abdomen with the skin removed between them and the abdominal muscle repaired? I want to have the procedure done but I do not like the long scar across the lower abdomen.

Doctor Answers 12

Vertical scars in abdominoplasty

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The vertical scar is not a substitute for the horizontal scar that goes across the lower abdomen. But it is sometimes added to the horizontal scar in patients who have a large amount of excess skin. This is rare, but does sometimes occur in patients after gastric bypass surgery or in those who lose over 100lbs. It used to be more common when "open" gastric bypasses were common, and patients already had a vertical scar present.

Atlanta Plastic Surgeon
4.7 out of 5 stars 15 reviews

Tummy tuck can be done with vertical incisions

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Tummy tuck can absolutely be done with an up and down incision. In fact, this is often done for massive weight loss patients. A more typical horizontal incision is more easily hidden under clothes, but there are some indications for doing a vertical incision.

You should see a plastic surgeon who is certified by the American Board of Plastic Surgery. During the consultation, you should express your concerns about the lower abdominal transverse incision. The surgeon should be able to help you understand the pros and cons of each so that you proceed in the safest way possible. But a tummy tuck through a vertical incision can be done, in the correct circumstances.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Vertical or horizontal Tummy Tuck Scar?

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Hi Mary

About your tummy tuck plans...

No one likes the idea of having a scar. But everything we do is a trade. Most people are very happy to have a scar they can hide beneath their panty or bikini line with a tight flat belly, instead of excess skin hanging out above your bikini.

As far as the vertical scar. I always reserve this for patients with a Lot of horizontal laxity of their skin at the mid abdominal level. Most commonly I use this for patients who have lost a lot of weight, usually more than one hundred pounds. The reason for this is that it is a visible scar when wearing anything that shows your midriff.

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Vertical incision abdominoplasty will result in lousy flattening and pooch

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To best understand what you are asking IMAGINE the excess tummy skin was cloth but that you were working simultaneously on 2 DIFFERENT layers of cloth and that the ultimate outside appearance depended on how alterations to these layers affected the OVERALL appearance.

A Tummy Tuck (Abdominoplasty) is first and foremost a tightening of loose abdominal muscles. As the tightening is done and the muscles are moved to the center - so is the skin that is attached to them. BUT -- the skin does NOT move to the same degree despite the same tightening. The waist skin moves in a lot with great narrowing of the waist but the hip skin does not move in as much because of the "resistance" of the hip bones. This results in a different, non uniform skin excess along the midline.

Now let's consider where the most tummy skin laxity is located. In MOST people (especially post-pregnancy tummies), it is located centrally and in the lower tummy. The area where the muscle tightening does NOT move as much skin in as it does at the waist.

As a result, a VERTICAL SCAR ONLY abdominoplasty would nicely remove central loose skin but result in a lousy skin flattening and a pooch at the lower aspect of the scar. THIS is why a transverse scar is needed in most cases.

One more consideration. As Plastic surgeons we live and die based on our scars and their visibility. We are LOATHE to leave scars anywhere if we do not have to. A vertical scar is visible with most Spring and Summer women's clothes. While a transverse scar is hidden by ALL clothes and most underwear and bathing suits. Therefore, in terms of visibility a transverse scar abdominoplasty would give you the stomach flattening you need with the least visible scar.

But if you insist and you understand the trade offs of a vertical scar - than I am sure your Plastic surgeon would do what you ask for.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Vertical scar tummy tuck

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If you have a long narrow abdomen, you might actually get more skin off with a vertical scar rather than a horizontal one.  Most wouldn't want this though because vertical scars never heal as well as horizontal ones and they are impossible to hide. 


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Uually the vertical component is just that- a component of the operation, and usually, there is a horizontal component.

Most ps's don't really like the vertical part because it ususlly doesn't form a scar as nice as the horizontal one, and you can't hid it beneath underpants, etc.


Abdominoplasty Scars

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In and of its own, a vertical alone is not done because that is not where the majority of patients have issues with as far as skin redundancy and excess goes. Fleur-de-lis abdominoplasty is an option in patients with a lot of loose and excess skin as in patients after massive weight loss. This involves removal of skin in a horizontal and vertical vector.

What I believe you are referring to is just using a vertical incision which in the mind of many is not acceptable when compared to the lower horizontal incision which can be hidden very well, as the vertical cant be.

Hope that answers your question.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Vertical incision abdominoplasty

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Though rarely requested, the vertical abdominoplasty, occurs in 5% of all Tummy Tuck surgeries. Make sure you use an experience board certified Plastic surgeon to perform this.

Best of Luck!

Vertical Abdominoplasty

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The verical abdominoplasty is not uncommon. The type of abdominoplasty incision that is made depends on many facturs including previous scars, the dimension and direction of skin excess and patient preference. Your plastic surgeon should be able to go through all the options available and suggest what might be best for you.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

Vertical incision abdominoplasty is sometimes useful.

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1) This is a topic of great interest to me, and I have written about it. You should know that the vertical scar can be quite noticeable.

2) When there is a LOT of excess skin, we sometimes use both a vertical and a horizontal scar.

3) Patients generally accept the scar very well, IF they love their new flat stomach.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.