On the morning of surgery, before the surgery is begun, a marking pen is used to design the incision that will be made. This is designed to be as low as possible. It is also designed to be as even and symmetric as possible. This is determined using careful measurements that are taken before surgery and again in surgery, before the incision is made.
The incision is often made at a level just above the pubic area. If a woman has had a C section in the past, the incision is made so that it at the same level, or is below the level, of the C section scar. Designing the incision here ensures that the final scar will be hidden when wearing underwear.
The length of the incision varies. In general, the more loose skin there is, the longer the incision has to be. The incision for a full tummy tuck will usually extend across the entire lower abdomen. The final length of the scar created will be reviewed and discussed with you in detail during your consultation.
Once the incision is made, dissection continues down to the level of the abdominal muscles. At this point, the direction of the dissection changes. Instead of going down to deeper layers, it stays above the level of the muscles and begins to head up, toward the belly button.