The most important part of getting a scar below your panty line, is to talk to your surgeon about the scar during your pre-operative appointment. Ask your surgeon WHERE the scar will be. Ask him to outline the scar location on your belly. The scar will not end up being any lower than where he draws it because tummy tuck scars do migrate slightly upward following surgery. The morning of surgery you should have another chance to review the scar location. In summary, the reasons why patients get a thick and noticeable tummy tuck scars are: Too much tension put on the skin during the closure of your skin during surgery 'Skin edges' have too little blood supply The surgical markings are not put below the bikini line The first two points relate to the type of procedure performed by the surgeon. The last point should be observed regardless of technique used. As another surgeon on this thread has noted, the tummy tuck scar does migrate upward. For this reason, the surgical markings should be made well below the panty line. In terms of tummy tuck surgical techniques, I believe that the Lockwood technique puts the least amount of tension on the skin and results in thinner scars. When the skin is under high tension, the scar tends to be thicker. Please read my blog post below to learn more about the Lockwood technique used in the Tummy Tuck Procedure. Dr. Ricardo Rodriguez Baltimore Plastic Surgeon