How Does a Surgeon Know Where to Cut the Hole for the Belly Button?

Meaning, the upper part of the abdomen will be pulled downward so how would they determine where to make the incision on this section of the skin to pull the bb through?

Doctor Answers 18

Belly button position

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When doing a tummy tuck, the surgeon usually cuts around the belly button leaving it attached to the underlying tissue. the skin flap is now brought down over it. a hole is made in the skin flap and the belly button brought through. Siting the position for the belly button is done in dirrerent ways. I use an instrument with a cuved point that I line up over the belly button and can feel poking against the skin flap that I have pulled down. Typcally the higher we can inset the belly button the more esthetically pleasing it is.

Peter Fisher MD

Belly button placement

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The most important thing to get right in placement of the belly button to to assure that it is in the midline. When I mark the abdomen before surgery, I always mark the midline carefully to make sure it will end up in the midline. I also check to see if the belly button is off to one side pre operatively because it often is.

Where does you belly button live?

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The umbilicus or "belly button" is the remnant of your attachment to your mother before birth. It has no biologic function after birth.

It is located at the mid abdomen, at the level of your iliac crest (hip bone). It also corresponds to the bifurcation (splitting) of the intra-abdominal aorta (large artery carrying blood from your heart) into left and right lower extremities.

When performing abdominoplasty, there are key landmarks used for placement of the umbilicus. A line is drawn from the xyphoid (small pointy bone at the end of your sternum) to the mons pubis (pubic bone) down the middle of your abdomen, then crossed with a line transversely at the level of the superior iliac crests (hip bones).The umbilicus is placed at that cross section.

Hope this helps.



Creating an aesthetically pleasing umbilicus at the time of an abdominoplasty

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It is important to not only locate the umbilicus in in the midline but to make it appear as natural as possible since this is the most visible portion of an abdominoplasty.  There is some variation in the location of the umbilicus and in some women it is not in the midline.  I generally drop a plumb line down from the xyphoid, or lower portion of the sternum.  On the horizontal plane the umbilicus should be at the level of the superior aspect of the iliac crest.  This can vary up or down about 2 cm.  

Belly button positioning

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Positioning your belly button (cutting the hole) during a tummy tuck is achieved using fixed anatomical landmarks including your sternum (breast plate) and your iliac crests (hip bones).

All the best,


James Southwell-Keely, MD, FRACS
Sydney Plastic Surgeon

Tummy Tuck and Belly Button Position

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In general, the belly button is the one structure that doesn't significantly change position in a tummy tuck surgery.  In most cases, your surgeon will mark the midline of your abdomen prior to your surgery.  Once the incision is made around the belly button and the abdominal skin and fat is lifted and advanced downward, your surgeon will feel where your belly button falls on this vertical line (remember the belly button remains attached to your underlying abdominal wall).  Once your surgeon has felt where your belly button is attached, he/she will make an incision in the overlying skin, creating a hole for the belly button to pass through and suture it back in place.  Best wishes. 

Location of belly button (umbilicus) in tummy tuck (abdominoplasty) surgery

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The umbilicus should be at the same location as it was before surgery.  The skin is usually advanced downwards and tightened, and the 'new' belly button is actually same as the old belly button, just coming out at a different place on the tightened skin.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Belly Button Placement is Set by Nature

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The umbilicus (belly button) lies between the level of the anterior superior iliac crests (hip bones), and two finger-breadths below it.  I have found this true in just about everyone - thin, obese, and in-between.  It is where it is, attached to your abdominal wall, so as surgeons, we can't do much about that when performing abdominoplasty.  The hole isn't created until after we have brought down all the upper skin - the hole is made directly over the umbilicus, very simple.  We do have options as far as the shape and scar that is created.  Most surgeons have a preferred way of doing it.  Ask your plastic surgeon if you have specific questions or concerns about this.

Belly Button Position with Tummy Tuck

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The actual position of the belly button does not change very much during the tummy tuck procedure.  It is the skin that is loosened and pulled down over the belly button that changes position.  Once the amount of extra skin to be removed is determined then a small incision is made over the belly button and it is brought into this opening and stitched in place.

Where is the Belly Button Placed During A Tummy Tuck?

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Dear NevertooLate_at52,

A tummy tuck is a great way to tighten the abdomen.

During a typical tummy tuck, the abdominal skin is lifted and pulled downwards, and the extra skin is removed in order to tighten and flatten the belly. The underlying abdominal muscles may also be tightened, and liposuction is often performed as an adjunct.

During the procedure, the belly button is left attached to the underlying abdominal wall. Once the extra abdominal skin is removed, a new opening is made for the belly button at this same location, which usually corresponds to the level of the top of the hip bones in the midline.

I hope this helps.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.