Belly Button Size / Shape After Extended Tummy Tuck

We get an interesting amount of questions about muscle plication on this forum.  Your photos imply that you probably wound't have benefitted much from plication although your history suggests that the muscles are probably separated.  If your abdomen is full and tight in the resting position from being overweight then there is no real point to plicating.  It doesn't improve your figure as much if you are full framed.  Photos can be decieving so only on examination will your surgeon know.  The belly button probably will need a revision where they make it a little bit smaller and that will help.  Over time they reduce in size but not much.  Best wishes,

After looking at your photos, it appears that the surgery itself was a success.  As far as muscle plication, it is hard to say for sure whether or not it would have been necessary, pictures can sometimes be deceiving.  I usually examine the patient prior to surgery to determine whether there is any diastasis, (muscle seperation) but ultimately it is what I find at the time of surgery that determines what I do.  However, I must say that I think your belly button has been inset much too large.  It is unlikely that this will "shrink" with time. The good news, however, is that you can have a revision that should make your belly button look quite acceptable.  The belly button is the make or break of the operation.  You can get a great, flat abdomen, but with a large, crooked or otherwise cosmetically unacceptable belly button, what good was it to have the surgery after all? Good luck!

It's hard to tell from your picture, but could it be that you have a cotton ball or gauze dressing in your umbilicus? If so, this will be removed when your umbilical sutures are removed. Though I do not personally use this type of belly button bandage, I have seen surgeons who feel that they enhance the funnel shape by doing this.

I'll bet everyone feels silly if this is indeed the case!

Your (early) result looks good, though I too am curious why a rectus sheath plication was not performed. I suspect the majority of PS would do one, but each case is unique and either you trust your surgeon's judgment or you don't. Sounds like he was honest in telling you, so why question his surgical motives and decision-making now?

Take care, and recover well!

Please keep in mind that your result will change a great deal in the coming weeks and months.

It is possible your umbilicus will contract - only time will tell.

It is the case that the occasional patient will not receive a muscle repair, but it is difficult to understand why you would not have.

You need to keep in touch with your surgeon to ensure your questions are answered and you get the best possible result.

Thank you for your photos. The postoperative belly button looks large, unnaturally round and I doubt that it will shrink with time. Looking at your preoperative photos, you do have muscle laxity and I'm surprised that your plastic surgeon did not do a muscle plication. All these I discuss with my patients during the initial consultation and the preoperative visit. I design the belly button on my patients differently to create a more natural look, hide the scars and not to look like someone applied a hole puncher to your belly button. You can see examples on my site at bellevueplasticsurgeons.

Understandably, the appearance of the umbilicus is of great importance to many patients undergoing tummy tuck surgery; after all, it may be the only telltale sign of having undergone the tummy tuck surgery when the patient is wearing a swimming suit or undergarments. The umbilicus should be positioned carefully; if it is too high or too low, it may be a sign of tummy tuck surgery. Ifit is too round or slit like it may also look "surgical". Most patients prefer a relatively small and oval-shaped umbilicus. I hope this helps.

A full abdominoplasty requires the surgical creation of a new belly button. Creating the new belly button, which is called an umbilicoplasty, is a part of tummy tuck surgery that requires a great deal of attention and finesse on the part of the surgeon. My goal is to create a new belly button that, as much as possible, resembles a 'natural' belly button. Natural belly buttons do NOT look like a perfect circle, and circular umbilicoplasty scars are a tummy tuck dead giveaway.

The technique I use for umbilicoplasty is designed to create a slightly 'hooded' appearance to the upper half of the belly button, an appearance that is generally considered fit and athletic. Not all patients have the goal of wearing a two-piece swimsuit, but many do, and I want these patients to be able to do so without feeling self-conscious about the appearance of their new belly button.

After and tummy tuck the belly button often looks larger due to swelling. Over time I have found that the size of the belly button does get smaller. In terms of your muscle repair, after having 3 children I would think that you would have some laxity and need the muscles sewn together in the mid-line.That is very standard for a tummy tuck for most people.

You are way to early to worry about the final rsult of your umbilicus. It will take some time for the swelling to dissipate.

The lower tummy tuck scar can be concealed under clothing, but the belly button scar can be visible and make or break a tummy tuck result. It is important for those considering tummy tuck to pay attention to the belly button in the 'before and afters' as each surgeon may approach this area differently. I don't think that the diameter of the belly button scar will get smaller during healing, though the scar can become paler. Muscle repair too might have been nice. After full healing you can take matters into your own hands, with further weight loss and muscular strengthening.
Best of luck,
peterejohnsonmd