I recently had a full abdominoplasty with Muscle Repair. I'm 5'2 and 115 lbs. My plastic surgeon is board certified and is highly regarded, and his photos looked good. He told me on my first post-op visit that my belly button did not turn out well. It is a completely flat scar, with no depth or hooding. He is willing to do a revision but said he's not sure what he can do, since he says I have little subcutaneous fat. I'm reluctant to do a revision if he can't fix it, and am wondering if another doctor could fix it. Any advice?
Umbilicoplasty Revision for Slim Patient?
Doctor Answers (13)
Umbilicoplasty after tummy tuck
At your height and weight, the thin layer of abdominal subcutaneous fat might have made it impossible to achieve any depth for the belly button. If, however, there is a little fat around the umbi it can be re-opened and stitched down to the muscles and the skin brought down to give more depth and character.
Remember that sometimes your body won't allow even the best plastic surgeon to give you exactly what you had hoped for.
Web reference: http://www.randcosmeticsurgery.com
Umbilicoplasty After Tummy Tuck
I think your doctor shouldn't jump to conclusions. When I redo the belly button during a tummy tuck I suture or stitch the top of the belly button to the fascia or the thick layer of tissue over the muscle. This pulls the belly button down to create the depression that women have. However, unless it's 6 months out your surgeon is jumping to conclusions (unless he knows what happened during surgery).
So give it time and if it's not good after 6 months see someone who can create a good belly button.
Umbilicoplasty (Belly Button) revision
The outcome of Cosmetic Plastic Surgery is commonly not only dependent on how we, the plastic surgeons, perform an operation ("play the cards") but also on your presenting anatomy ("the cards you deal us").
Post-operatively, a round belly button (not a vertical slit), " innie" with depth and hooding is the goal of a well done umbilicoplasty (which is part of the Tummy Tuck (Abdominoplasty) procedure. But it is not always completely achievable.
The deep / innie look is dependent on the balance between your skin's subcutaneous fat, the length of your umbilical stalk and the extent of muscle repair / plication done during your tummy tuck (the more - the better as it shortens the stalk and pulls the umbilicus closer to the muscles).
A conservative muscle repair in a thin patient with a moderate to long umbilical stalk which are unrecognized or not fully addressed will generate an average to poor result. Such patients require their umbilical "cup" to be stitched to the adjacent muscle fascia lining to BOTH "shorten" the stalk and force the skin to come down to the umbilicus creating an attractive, deep belly button.
If the appearance of your belly button is important to you, do not settle for this result. I would advise you seek out qualified Plastic surgeons and see what they offer. Your present result could be vastly improved.
Dr. P. Aldea
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Your surgeon may be correct
The depth of your belly button depends on a couple of factors:
- How short your umbilical stalk was in the first place, and if it was shortened intra-operatively.
- How thick your abdominal flap was at the time the belly button was inset into it.
You describe yourself as thin, and certainly if you had a full tummy tuck, your abdominal tissues are stretched even thinner. If your belly button was not shortened intra-op (it probably was not, since you are not obese), then my advice would be to wait until your abdominal tissues relax a bit. Some tissue laxity around the belly button might improve its shape and depth.
I'm sure some of the more experienced surgeons on this forum have some tricks for this problem, so stay tuned for their answers.
How to make a nice umbilicoplasty on a slim patient
Your surgeon is right that making a nice belly button on a slim patient is very difficult, because there is no way to create the natural depth. The best thing in my experience is to try to create more of a hood across the top, which can be done under local anesthesia. it's worth giving it a shot because a nice umbiilicoplasty is one of the hallmarks of a good abdominoplasty and I am sure your plastic surgeon want to make it better.
Hiding the Belly button scar in thin patients
Tough problem! A lack of subcutaneous fat is a contributing cause, or leaving the umbilical stalk to long may been a factor. To assist you further a photo would have been very helpful. Tacking the skin very close to the fascia and doing a little fat transfer might just do the trick enough to get you happy.
Need to see the problem...
In order to figure what might be possible I need to see what the problem looks like. An examination is better. There might be something to do but without looking at you it is hard to predict.
John Di Saia MD
No definition of umbilicus
Without seeing photos of your before and after, it is difficult to tell you if it would be worthwhile for you to under go an umbilicoplasty revision. There are several things that can create a not-so-perfect belly button after abdominoplasty, and some can easily be corrected, and some are more difficult. If you have lost confidence in your surgeon, I would recommend getting a second and possibly even third opinion. You may end up having more confidence in your original surgeon if you hear the same thing from others, ore you may find someone who can give you the results you want to achieve. But I would advise you to discuss this with your original surgeon so that he/she has the opportunity to go over it again with you. Good luck!
Umbilicoplasty following abdominoplasty
I have observed this in extremely thin patients. It is difficult to create a hooded or deep umbilicus there is no thickness to the walls of the umbilicus.
A photo will be helpful
If your doctor does not feel comfortable to do the revision, I would suggest that you follow his advise. He has opearted on you and he knows the anatomy of your abdomin and also the reason that it did not turn as you both expected.
Please submit a picture.
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