Most people have a bulge both in the lower and upper abdomen, however some don't have any in the upper and some have it centered around the umbilicus. The patient in the attached VIDEO demonstrates the applicator being applied mostly to the lower abdomen but the belly button is sucked into the applicator along with the lower component of the upper abdomen.
That's why I examine all patients in consultation and determine exactly which applicator(s) will be used and exactly where it will be positioned. When I have treated the mid abdomen including the belly button it has been well-tolerated except in one patient. In that circumstance, the patient noted a lot of sore pain as soon as the applicator's suction commenced. I had the treatment stop immediately and we were able to treat below the umbilicus without the same pain. There had been no evidence of hernia felt in consultation, but there is no reason to subject a patient to such pain, and rather than being dogmatic, since no one can guarantee the patient didn't have some condition that is not clinically recognized, I listened quickly to their concerns and any risk was then avoided. They did very well with the treatment.