Tummy Tuck with or without a vertical scars
From your photos, you appear to have very little excess skin below the belly button. A traditional tummy tuck ususally removes all the skin between the belly button and the “bikini line”. That would not be possible with your anatomy. However, your tummy tuck could be completed without a residual vertical scar by not cutting around the belly button, and freeing its stalk from the abdominal wall.
The muscles could be repaired (if needed) and the excess skin could also be removed. Your belly button would placed be approximately 1-2 inches lower, and still give you a natural looking abdomen with the final incision in the bikini line. (Ricardo Izquierdo, MD, Oak Brook Plastic Surgeon)
Concerns about a high abdominoplasty incisions
It is extremely improbable that a potentially higher incision will be able to be lowered down significantly after 6 months or even much longer for that matter. Instead, the incision should be kept low as in the bikini line. The cause of the vertical scar would be from the old site of insertion of the umbilicus as it needs to be repaired.
Given your anatomy as seen by the photos, it is highly unlikely that all the skin from your pubis to the umbilicus would be able to be removed, Another option to address this issue (which has already been mentioned) would be to “float” your umbilicus down to a lower position on your abdominal wall (that is, not detach it from the surrounding skin). Given the high position of your umbilicus, this may be a reasonable possibility. (Steven Turkeltaub, MD, Scottsdale Plastic Surgeon)
Can I get a full tummy tuck without a vertical scars?
The vertical scar that oftentimes is necessary after a full tummy tuck is from closing the round small belly button “hole” if it can not be brought down low enough to below the level of the incision so it can be removed.
The scar is rather short, and is preferable to raising your whole tummy tuck scar to a much higher location than ideal just to avoid this short vertical scar. I have seen surgeons do this, and I have never understood it.
The tummy tuck scar heals best and is best concealed when it is low, just above the pubic hair and follows the lines of the inguinal crease or close to it. You have a long torso, your belly button hole will NEVER move down far enough to remove, so you will indeed have a vertical scar.
Your torso is long enough and your belly button is high enough that you MIGHT be a candidate for a full fascial plication with an umbilical float, but this would need to be determined on exam and based on whether your belly button could stand to move down 1-2 centimeters, whether you have little enough skin excess above the belly button that would be improved by this maneuver as opposed to needing a full tummy tuck degree of skin tightening, and whether your belly button is so stretched out that retaining it would be a compromise.
By the way, is that a right subcostal gallbladder scar I am seeing in your photo? If so, the increased risks in terms of blood supply with a full tummy tuck must be considered. (Robert M. Grenley, MD, Seattle Plastic Surgeon)
You carried your babies low and this caused the belly button to shift too high. You would benefit from tummy tuck with no belly button incision. I would lower your belly button without making incision around belly button. You can check my web site for examples This patient had same problem as you and I did lower the belly button. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon) Based upon your frontal photo view, your belly button location is higher than most patients. Full abdominoplasties or tummy tuck without scars usually remove the skin between the pubic rim and the belly button and place the “hip to hip” scar at the pelvic brim, where swimming sportswear can conceal the scar, simultaneously making a new opening for the belly button in the midline.
Since you have such a high belly button, the distance from your pubic rim to the belly button is a longer distance that presents this issue. You do not appear to have enough loose skin to have that vertical distance removed and still close the wound directly.
The options in your case include 1) raising the “hip to hip”incision above the pubic rim to allow the wound to be closed by removing less skin or 2) placing a small vertical scar in the midline to close the opening where the belly button was originally positioned to allow the “hip to hip” incision to be placed at the pubic rim. I would suggest the latter, since the lower “hip to hip” incision will be better concealed even if a small vertical scar in the midline may be visible.
This is more easily explained than a visible horizontal incision extending hip to hip. A consultation with a board certified plastic surgeon who can exam you and diagram for you the 2 options will help to direct you towards the option that is best for you. (David N. Hing, MD, Ann Arbor Plastic Surgeon)