When planning the incision placement for a tummy tuck, plastic surgeons try to design the skin to be removed in such a way as to keep the scar as low as possible so that there is the potential for the patient to be able to wear a two-piece bathing suit after the surgery without the scar showing.
The more extra skin we have to work with, the easier it is to get the scar lower with a standard tummy tuck. With a mini-tuck, it is much easier to keep the scar very low and, since it is also a shorter scar, it can generally be covered up by most bikinis.
Whether or not a C-section scar can be removed and replaced with the tummy tuck scar depends not only on where the scar is, but what type of tuck is going to be done and how much extra skin we have to work with. The determining factor as to how low the scar can be placed with a full tuck is how much extra skin is present above the umbilicus. When there is a lot of excess skin the final position of the scar will be lower than if there is not much excess. The lower the C-section scar placement, the harder it is to take it out with a tummy tuck; particularly with a full tuck. With a mini, it is not usually a problem.
Sometimes, the position of the C-section scar and the desire for a very low scar by the patient determines the type of tuck to be done. Fortunately, most patients who are considering having a tummy tuck have enough excess skin and their C-section scar is in a position such that removal is not a problem.
Other scars on the abdomen may also dictate what kind of tummy tuck is done. Some midline scars do not allow for an adequate pulling down of the skin and preclude a full tuck. Similarly, the old angled gall bladder removal scar that runs obliquely across the right upper abdomen just below the rib cage may eliminate the possibility of a full tuck because of the blood vessels that were cut with the first surgery.
Bring Your Suit In
In some patients where the scar position is critical to their decision as to whether or not to have surgery, I have had them bring their bathing suit in to the office or to the surgery center so that I can mark the area that the suit covers in an effort to better hide their scars. Although this does not guarantee that their scars will be hidden, it does give me a better idea as to what I need to accomplish to satisfy their request. It is important, of course, to have reasonable expectations. I once had a relatively large patient who was having a big tummy tuck come in for me to mark her for surgery in a thong. She clearly did not understand the procedure.