How do we assess an abdomen for a tummy tuck?
There are a number of issues here. If you want to position the incision through the previous caesarian scar (which you should) then I think it likely that you would end up with a small T scar. However, after a year or so, the vertical stem of the T may be removed once the tissues soften up, leaving you with a normal transverse scar.
Whenever I anticipate this, I position the belly button a little higher than normal because the second operation (removing the stem of the T in a transverse ellipse) will bring it down a little. You appear to have an umbilical hernia and this should be fixed. Lastly, your abdomen bulges significantly and this is not all due to subcutaneous fat.
There may well be a permanent intra-abdominal component. Despite muscle tightening, and the removal of loose skin, you may still be left with a convex abdomen. Intra-abdominal fat cannot be removed. It may only be reduced by diet. (J. Brian Boyd, MD, Los Angeles Plastic Surgeon)
Tummy tuck vertical scar
You have an umbilicus hernia, and a hiperlaxitud of the vain of abdominal rectus muscle considering this it looks you have enough laxity from skin and from abdominal fascia and there is no problem to do a full abdominoplasty WITHOUT any vertical scar. you are a good candidate to perform a complete abdominoplasty reparing abdominal fascia muscles only with an abdominal smile scar and no vertical incision (Cynthia Disla, MD, Dominican Republic Plastic Surgeon)
Vertical Scar Needed For Tummy Tuck?
It appears from your photos that you have considerable laxity of you skin and abdominal wall. It is very unlikely that you would need a vertical scar. This type of vertical scar is caused by closure of the belly button skin after the upper skin flap is pulled down.
When it is necessary, it would be just above the pubis and easily covered by a bathing suit. In typical patients like yourself, I have rarely ever needed to do this unless it is a redo, if you had previous abdominal surgery or if you had too much intra-abdominal fat. None of these appear to be the case. (Martin O Toole, MD, Los Angeles Plastic Surgeon)
Tummy tuck- vertical incision necessary?
Because there is a long distance between the umbilicus and the C-section incision, you may be able to limit the abdominoplasty scar by having a small vertical incision. Your umbilical hernia should also be repaired at that time. (Brent Moelleken, MD, Beverly Hills Plastic Surgeon)
A high umbilicus coupled with a low C section scar should involve consideration of a vertical scar. However, in your case you appear to have a great deal of abdominal wall laxity that when repaired may allow for more effective length to avoid the vertical scar. Find a plastic surgeon with ELITE credentials who performs hundreds of tummy tucks each year. Then look at the plastic surgeon’s website before and after photo galleries to get a sense of who can deliver the results. (Kenneth B. Hughes, MD, Los Angeles Plastic Surgeon)
Based on your pictures, it is easy to understand why a plastic surgeon consult has discussed the potential need for a vertical scar with you. As you have noted, your C-section scar and your umbilicus is relatively high on your torso. Your choice would be, using a higher incision to perform the tummy tuck operation ( you would then have a 2 scars present) or accept the possibility that a vertical scar may be necessary to avoid too much tension on the midsection of your tummy tuck closure. My best advice to you would be to choose your plastic surgeon carefully. Allow him/her to communicate your goals and preferences carefully. Doing the before mentioned steps will allow you to achieve a very nice result with tummy tuck surgery, even if a short vertical scar is necessary.