Umbilical float vs full tummy tuck? (Photos)

I think you had a meaningful discussion with your PS. All his/her points are valid. I would imagine that after the skin is elevated and the muscle tightened, he/she can re-drape the skin and basically put the umbilicus back to where it is naturally located with removal of a SMALL amount of lower skin like a mini-tt. The confusion from all of the answers is because umbilical floats are rarely done with good reason. However, if you have an experienced surgeon, I think this is a valid option. Thank you for sharing.

He certainly seemed to understand the situation well. From your photographs, although I have not done an exam, it seems you may be a candidate for a full tummy tuck with a vertical midline scar. I say this keeping in mind that your abdominal muscle tightening will be significant which will allow the flap to advance even more downward.

The photos and your story show why your surgeon is considering an umbilical float instead of a full tummy tuck with a vertical scar. The choice between the two depends on several factors, and it sounds like your anatomy makes you a strong candidate for the float technique.
Umbilical float tummy tuckThis approach is usually reserved for patients with minimal upper abdominal skin and a naturally high belly button. It allows the surgeon to repair the muscles fully while avoiding an extra vertical scar. The belly button is released and repositioned slightly lower, but when carefully planned the change is modest and usually looks natural.
Full tummy tuck with vertical scarThis is chosen when there is significant upper abdominal skin to remove or when the position of the belly button cannot be maintained without extra tightening. It gives a very flat contour but adds a vertical scar that can be difficult to hide especially if it sits just beneath the new belly button.
Your surgeon’s reasoningSince your upper abdominal skin is limited, your belly button sits high, and you need complete muscle repair after twins, the umbilical float can achieve the contour you want while avoiding a scar that would be impossible to conceal.
Concerns about low belly buttonIt is true that in some cases patients feel the belly button looks too low. However, in the right candidate and with careful technique, the shift is small and often not noticeable. The key is proper planning and execution by a surgeon experienced with both techniques.
I hope this helps ease your anxiety. The fact that your surgeon re evaluated you and adjusted the plan to fit your current anatomy is actually a positive sign of thoughtful planning.
— Güray Yesiladali, MD

Thanks for your question! You do look like you're between a rock and a hard place, but your belly button is high enough that I think you will be happy with the float. I agree that the vertical incision would be very high. Best of luck!

The umbilical float is ideal in a patient who has a high belly button and not an excessive amount of abdominal skin and fat. From the appearance of your photos, you appear to be one of them. This is a decision a surgeon can make after examining you. If you're OK with the belly button being lowered 1 inch, you would be a candidate for this procedure.

No peri-umbilical skin tightening can occur with a float. 1.5 cm drift is still too far for a bellybutton to sit. It doesn’t matter where the vertical scar lands with a full; it will disappear. Long scar should be very low and match inguinal ligament down to low pubis.

In your side view, you can see your abdomen is protruding anteriorly. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. I do not believe you have enough excess skin that your umbilicus scar can be pulled down and excised.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question and photos. An umbilical float can be done with a full tummy tuck, but I would not recommend that in your case. Your gut feeling is correct. A small vertical scar is more acceptable with a low pubic bone level abdominoplasty incision vs a high incision with an umbilical float that cannot be concealed. Once your muscle separation is fixed, you will have more loose skin than what you see now. I would recommend a full abdominoplasty with a low pubic bone level incision, and an umbilical transposition (not a float, leave it where it is). The trade off is a small vertical incision, which can be removed later. A low umbilicus, gives an aged look to the abdomen. I would stay with your surgeon's original plan (what you understood and paid for), or seek out other consultations. Remember, the results are permanent and cannot be undone. Good luck. See attached example.

I am not a fan of the umbilical float. I would rather have the small vertical scar but I don’t think that will even be necessary

Your intuition tells you something is amiss, perhaps you are right. Nearly all women present differently post-partum, but nearly all women want the same result: a naturally flat tight fit appearing abdomen with hourglass shape, aesthetic belly button, and no visible scars in their preferred styles. So it follows that tummy tuck procedures must be modified and individualized to deliver the best outcomes for all. You need a type 1, 2, or 3 tummy tuck.