Low Belly Button After TT. What Can I Do? (photo)

Unfortunately, you have had a long-incision abdominoplasty with umbilical "float" when you were actually a better candidate for a full or extended abdominoplasty with "standard" umbilical transposition. (That surgical judgement may not have been evident pre-operatively, but it clearly is now.) 

Now that the umbilical stalk has been transected surgically, the only blood supply to the umbilicus is through the surrounding skin dermal capillaries. Any revisionary surgery that might attempt to remove the (still-remaining) excess lower abdominal skin and transpose the umbilicus to a new high(er) position would result in its loss of circulation and ischemic death of the belly button.

Given these facts, I would recommend that you let things heal and soften for at least 3 months (6 would be better), and then plan on additional surgery to remove the skin between the umbilicus (including the present umbilicus) and old scar (including that scar), re-elevating the abdominal skin flap to the lower breastbone (xiphoid), making sure a proper muscle plication was done from xiphoid to pubis, reclosure and then creation of a neo-umbilicus in the proper position. It won't be as good as your "original equipment," but it can be a very good simulation if properly designed and executed. I truly believe that other than accepting your present appearance, this is your only realistic chance for a better aesthetic outcome.

When you are ready, obtain several in-person consultations with ABPS-certified plastic surgeons in addition to your own surgeon. Options can be discussed, but the one I outlined above is the only viable option considering the blood supply to your belly button has been made dependent on the very excess skin that remains. Only a "new" umbilicus will allow removal of the malpositioned one along with the remaining excess skin. Good luck and best wishes!

This is one of the reasons I don't like to float the belly button. Unless the skin excess above the navel is minimal, this is what happens when you mobilize the skin between the navel and the rib cage.

 

There are better ways to handle this situation during abdominoplasty but at this point those options don't exist.

 

There are some ways to manage this but they are not great. I would suggest that you discuss this with your surgeon and get some opinions from other surgeons who have the opportunity to examine you.

Results in plastic surgery have to do with accurate and precise planning and then selecting the right operation for the right patient to meet their expectations.  It seems clear that you would have been a better candidate for a standard abdominoplasty.  Why your surgeon opted for an umbilical float procedure is unknown at this point.  The proper position for the umbilicus is in a range 2 cm above to 2 cm below the top the pelvic crest and in the midline.  I have had patients in the past that originally had a float procedure and were subsequently converted to a standard abdominoplasty.  I would wait at least one year and then understand that there is a risk of wound healing problems around the umbilicus. Good  luck,  DR. Z

After an umbilical float abdominoplasty, the belly button only get its blood supply from the surrounding skin, not from underneath as after a standard abdonimoplasty.  Therefore, moving the belly button up could very well could cause umbilical necrosis.  One alternative could be excising the current belly button and reconstructing a new at a more desireable level.  Discuss this with your surgeon.  lhc

The belly button can be moved up , but it will require a small vertical scar.It could also be re positioned higher ,but the original belly button will result in a scar

You do have a lot of extra skin so your best bet would be to re- do the  tummy tuck

Unfortunately, the blood supply to the belly button is now based on the skin surrounding the belly button, than from the umbilical stalk.  Thus, trying to move the belly button at this point will likely compromise the blood supply and may lead to necrosis of the umbilicus.  You can try to base the umbilicus on a dermal pedicle (random flap) and reposition it hire, but this will result in a vertical scar under the belly button much like doing a breast lift.  You can check out vertical mastopexies pictures to see what this might look like.