Thank you for the question.
The appearance of the bellybutton after tummy tuck surgery is very important given that it is the only area of “scarring” that is visible after the tummy tuck surgery when a patient is in a bikini or wearing undergarments. Therefore, keeping the scar as hidden as possible is important. Also, a large round bellybutton is a telltale sign of a person having had a tummy tuck procedure. Generally, an oval shaped smaller appearing bellybutton appears to be more “natural”.
During the tummy tuck procedure is important to avoid compromising the blood flow to the umbilicus. This can happen if the surgical dissection is too close to the umbilicus. Patients who have umbilical hernias and very thin/stretched overlying skin are more prone to develop problems with blood flow/ necrosis to the bellybutton.
During the procedure the belly button should be incised such that it is large enough to create and “inny” appearance but not too large to appear surgical ( as discussed above). Importantly, the opening that is made in the abdominal wall skin ( that is draped down during the tummy tuck procedure) should also be of appropriate size ( again not too big or too small).
The technique used for suturing the belly button to the abdominal wall skin is also important. I tried to keep the suture line hit in “inside” the umbilicus and avoid any external sutures ( that can leave suture marks later).
I hope this helps.