Vertical Incision Necessary For Tummy Tuck? (photo)

I met with a PS today for a consultation and I really liked personally and trusted his medical opinion. However, he insisted that a vertical incision in addition to the horizontal one would be my best option. Since there will be no way to hide the vertical scar, I am very nervous about it. You'll see in my second photo that he's right, pulling in and removing the skin vertically would be a good method but I wanted to get the opinion from the doctors here about if it is necessary?

Doctor Answers 11

Do I Need a Vertical Scar Abdominoplasty?

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First of all, it appears from your pictures that you have lost a significant amount of weight and I want to congratulate you!  With regard to the vertical incision, it is rare that this incision is ever needed and based on your photographs, I do not believe that it should be necessary in your case.  I suggest getting the opinions of other experienced, board-certified plastic surgeons in your area before moving forward with your procedure.  Best wishes!

Alpharetta Plastic Surgeon

Tummy tuck needed

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Based on your photographs, an abdominoplasty would be your best option. Whether or not you need a vertical component can only be assessed after examining your abdomen. Seek the opinion of several board certified plastic surgeons before choosing your surgical procedure.

Donna Rich, MD
Webster Plastic Surgeon
4.5 out of 5 stars 33 reviews

Vertical incision for a tummy tuck

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You can probably go either way (with or without the vertical part) but you will most likely get flatter with the vertical incision included. 

Vertical scar almost never needed in abdominoplasty

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Your instincts are correct.  You do not need a vertical scar.  This can be handled with a horizontal scar, and liposuction simultaneously.  You may wish to look at some photographs of patients treated this way (see link below) and see if you find the results acceptable.  There are some unusual situations of massive weight loss, or when a patient already has a vertical scar that may be exceptions.  You are not one of these.


A vertical scar is forever and best avoided.  I flex the operating table to keep the horizontal scar as low as possible and virtually never use a vertical scar, which is unsightly.  In plastic surgery, there is no shortage of different opinions!  Your job is to get several and try to decide.  Photos are the best way of evaluating surgeons' results.



Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Vertical scar on tummy tuck

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Thanks for the excellent pictures.  It appears you have lost significant weight, congratulations.  I wanted to tell you that your plastic surgeon is right that a vertical scar would improve your contour.  The scar can heal well, but you are correct that it is hard to hide.  I have had patients like you who have had only the horizontal scar tummy tuck first and been perfectly happy with the final result and others who added a vertical component at a second surgery if they desired more contour improvement. No bridges are thus burned if you want to avoid the vertical scar at first.  Good luck.

Vertical scar in tummy tuck

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Dear Pastiche,

    I have been in private practice 25 years and performed over a thousand tummy tucks. I have never used a vertical scar in my tummy tucks. It is un-necessary , the scar is very un-atractive and often the scar is hypertrofhic ( thick and hard ).  Get a second and even third opinion. Be sure to select an experienced board certified plastic surgeon.

                     Best of luck,

                                         Dr Widder

Vertical incision after weight loss can be worth the scar

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A vertical incision will allow your waist to be narrowed and overall will give you a very good result when added to the tummy tuck. We think your surgeon is on the right track. The scar, while visible, might be worth the result.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Best Option for Tummy Tuck?

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Thank you for the question and pictures.

Based on your pictures, I think you will be an excellent candidate for tummy tuck surgery; it would be in your best interests to have this procedure done when you have achieved a long-term stable weight.

In regards to the exact procedure performed, I would suggest that you continue to your “homework” and look into the variety of options available as well as the potential risks/complications associated with each option. For example, based on your pictures, you may be an excellent candidate for an extended tummy tuck operation as well.

Keep in mind, that additional in-person consultations may be helpful to you;  as you continue to gather information, you will eventually feel comfortable with the choice of operation ( as well as the potential downsides associated with the operation).

Best wishes.

Should a vertical scar be used for a tummy tuck?

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There are several ways to "skin a cat"! It looks like you have lost a lot of weight which results in a lot of skin that needs to be removed. The scar will need to either go all the way around or up and down. You will need to make some decisions depending how you feel about the location of the scars vs any amount of skin excess that is left over.

Vertical scar for TT

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Yes it is true that it is not going to be possible to hide the scar if your abdomen is uncovered after a vertical tummy tuck.

But in this setting, the scar should be well worth it for the added improvement. Even a worse than average vertical scar will probably yield a better abdominal appearance than would a "normal" tummy tuck which would certainly leave considerable excess abdominal tissue.

I concur with your surgeon's recommendation.

Best wishes.

Jourdan Gottlieb, MD
Seattle 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.