Patients with skin looseness above the belly button, or significant overall skin looseness, will typically require a full tummy tuck or some version of it.
Patients who only need a minimal amount of skin removed, and no fascia tightened typically benefit from a mini-tummy tuck. The mini tummy tuck is especially suited for patients who need a nice scar revision of their C-section scar overlap. Doing a mini tuck in a patient with fascial looseness all the way above and below the belly button will often result in a bulge in the upper abdomen from the untightened fascia. The procedure is simply not best for a patient that needs their fascia tightened.
For patients who have fascial looseness and miimal loose skin, we typically recommend the Hybrid tummy tuck (R), which is a full tightening of the fascia through a small lower abdominal incision. It is not necessary to make a hip to hip incision in such patients to obtain an excellent result. Special instruments are required for this procedure, including an endoscope and special retractors.
There are many in between versions of the main subtypes above, and every patient's procedure should be customized to their anatomy and needs.
A belly button hernia can be repaired with any of the above procedures through a separate incision around the belly button.
Plastic surgeons typically view hernias differently than general surgeons, and prefer to plicate them away rather than use sheets of mesh without a plication.