When You Have a Tt when They Pull the Bottom Pubic Area Up to the Top Does It Do Any Tighting to the Outside I Have Noticed Some

When you do a tummy tuck, you don't want the pubic area and scar line pulled up, you want it stay low under the bikini/underwear line.

How to do this?  First pull the pubic area and the front of the thighs up when the pre-operative marking is done. Make sure this line is covered by the bikini  preferably by having the bikini underwear in place when the marking is done.  Bend the front of the thigh to ensure that the line falls in the thigh crease which is where the bikini will be. This ensures that the line of incision will not go higher and be visible when tension is applied at the time of repair.

This gives an anterior thigh lift as well as improving the abdomen so they both blend in as a smooth continuous youthful surface. 

It is also possible to minimize the upward pull on the pubic area by blocking that tension with sutures from the upper flap down to the abdominal wall at the level of the umbilicus and having the main tension that smoothes the skin out laterally where the pull is desirable.

This was first described by Dr. Lockwood as the "High-Lateral Tension" tummy tuck, and added to by Dr. Le Louarn of Paris as the "HIgh Superior Tension" tummy tuck. These techniques avoid the problem you have observed where the pubic hairline and scar are pulled up too high.

I incorporate both of these techniques in my tummy tucks.

   When I perform tummy tucks, I put the scar as low as possible with the lateral portion of the scars low as well (no smiley face).  That waythe scar above the pubic area and the scar to the sides are both low and not visible in clothing.