What Should I Do About My Belly Button Closing After Tummy Tuck?

An umbilical scar (belly button) after a tummy tuck can be revised once the tissue has softened up, this may take 9 months or a year after surgery. The scar tissue can be excised and a new belly button created. You can also seek out a second opinion in your area but I would express your concerns again with your plastic surgeon and see if he has a good solution. Steroids have some role but can be "re-open" a belly button this has already closed and scarred in.

Best wishes,

Dr.Bruno

Without more information, it is impossible to answer your questions.  It would also be helpful to show your before and after pictures.  If you are having unusual healing problems that it is good that you are following closely with your surgeon. 

You do not state how far you are from surgery and how scarred in your belly button is. What I find that works well in the rare circumstances that this happens is use an ear plug. Take a soft ear plug and squeeze it and roll it thin and insert it into the belly button. This will help control the scar in the early healing phase, prevents closure and helps soften it up. You might have to wear it for a few weeks. I would try this first, before jumping into a revision which will create a larger, uglier or more scarred belly button. Good luck.

If your belly botton is small or closed because of the scar than perhaps revising the scar might help. Sometimes the blood to the belly button is not good and there could have been some delayed healing in the area causing the belly button to shrink. Also some peoples belly buttons are not so well formed and are sort of damaged after pregnancy. If any of this is the case you might actually need a little more done in order to re-create the belly button. In any event it's pretty minor. If you are forming keloids or think scars around the belly button be careful of further revisions because this could make it worse and difficult to correct.

Umbilical scarring after tummy tuck is different for each patient, and depends not only on the innate healing and scar-forming tendencies of each patient, but also on prior surgeries that can leave belly button scars and decreased circulation to these healing tissues, as well as whatever circulation the umbilical stalk has after it is separated from the surrounding skin during the performance of your tummy tuck. This can be diminished even without prior surgery in this area.

Sometimes there can be superficial infection that decreases circulation, slows healing, and increasing scarring, or it can just be due to the genetics of healing that some patients bring to the procedure. We, as plastic surgeons, never know in advance when we may end up with one or more of these concerns, though fortunately they are relatively uncommon. But do enough tummy tucks for enough years, and we all see this occasionally.

Your surgeon is offering correct advice, and no surgical revision comes with guarantees, so this is correct as well. Z-plasties are done in cases where scar contractures would benefit from lengthening--this is a time-honored and well-understood procedure that every plastic surgeon learns and uses when necessary or advisable. The Z-plasty flaps that an umbilical scar revision would require are tiny, and would themselves be subject to circulation and healing concerns, so your surgeon's judgment that more scarring is not advisable is entirely reasonable and best decided upon by the expert actually examining your scar, not any on-line consultant.

If you still have questions, seek additional opinions, but your surgeon has the best information about you and your concerns, and appears to be right on target here. A poor umbilical scar is not your surgeon's fault, nor is it something that requires you to find the "right" corrective technique. Your surgeon wants as good a result for you as possible, but the present situation is what needs to be dealt with, and the recommended options and not "right" or "wrong," they are possible procedures designed to improve things as much as possible.

Good luck and best wishes!