Belly Button After Tummy Tuck Surgery: Can It Be Moved?

For a full tummy tuck, all of the skin between the incision and the belly button is removed. In some patients, due to their not having enough looseness, this is not possible without creating a very high incision. I suspect this is the dilemma your surgeon faced.
There are various lesser procedures such as:
Mini tuck (short lower abdominal incision only, tightening of lower fascia only)
Endoscopic tummy tuck - no skin excision, full fascial tightening
Full incision, removal of skin from the lower abdomen --it appears as though you had had this procedure
Full tummy tuck with small vertical component. This may be a corrective option in your case; it would involve about the same incision as you have now with a small vertical incision going upwards. It is typically possible to convert your procedure to this one if you need additional upper abdominal tightening. If you are unhappy at several months' time after surgery, you may wish to discuss this with your surgeon.

I'm sorry to hear about your disappointing results following your tummy tuck surgery. It's understandable to feel frustrated, especially when the outcome doesn't meet your expectations.

Regarding your concern about the belly button not being recreated during your tummy tuck, this is indeed less common but can occur. Typically, in a tummy tuck, the belly button is repositioned through a new opening after the excess skin has been removed and the remaining skin tightened. However, if your plastic surgeon did not create a new belly button and instead moved it down, it suggests that anything above the belly button wasn't significantly affected or pulled down. This approach might have been chosen if there was a concern about not having enough skin to resect above your previous belly button without risking too high a scar or not being able to close the incisions comfortably. This could result in leaving some skin laxity in the upper abdomen, which seems to be your primary concern now.

Your surgeon's caution could have been to avoid a scenario where you might end up with a small vertical scar in your lower abdomen, which can happen if there isn't enough skin to pull down completely over the old belly button site. However, this doesn't seem to have fully addressed your needs or expectations regarding the appearance of your upper abdomen.

Since you still have significant loose skin and are unhappy with the appearance of your upper abdomen, it would be worthwhile to discuss revision options with your plastic surgeon. A revision might involve re-evaluating the amount of remaining skin and possibly adjusting the approach to tightening and repositioning the skin more effectively. Another tummy tuck might be considered to address the loose skin in the upper abdomen, potentially involving a different technique to manage the skin around the belly button more effectively.

Thermage, which you mentioned your surgeon has recommended, is a non-surgical option that uses radiofrequency energy to tighten skin but may not provide the significant correction needed for pronounced skin laxity resulting from previous surgeries and pregnancies.

I encourage you to have an open and honest discussion with your plastic surgeon about your concerns and the possibility of a revision surgery. If you feel unsure about the proposed plan, seeking a second opinion from another board-certified plastic surgeon could also provide you with more options and peace of mind.

Again, I'm sorry for your disappointing results, and I wish you the best as you seek a satisfactory resolution.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Although your post –operative pictures are helpful, it’s
virtually impossible to make a recommendation without pre-operative pictures,
your previous operative report and a physical examination.An operative report is essential to determine
why your umbilicus wasn’t transposed.Under these circumstances either an umbilical float procedure or a
mini-abdominoplasty may have been performed.This distinction is important because a previous umbilical float
procedure would significantly limit revisional surgery options.Your
post-operative pictures demonstrate excess abdominal skin above the level of
the umbilicus.Assuming an umbilical
float procedure wasn’t performed, you may be a candidate for a revisional
procedure.Under these circumstances,
your flaps can be re-elevated and the umbilicus transposed with removal of
excess abdominal skin and fat.Your
lower transverse abdominal incision can be kept low, but a small vertical
incision may be necessary where the umbilicus was preciously positioned.If an umbilical float procedure was performed
options for revisional surgery are more limited.For
these reasons, it’s important to thoroughly discuss your options with your
plastic surgeon.If you’re not satisfied
with the response, a second opinion may be necessary.

I would agree with the other surgeons here in stating that you probably had a midi type abdominoplasty which is halfway between a full and a mini. Generally the belly button is floated as it is left attached to the skin,.. Now that this has been done, It is difficult to perform a full tummy tuck without losing the umbilicus entirely.

You appear to have had a very conservative abdominplasty.  Not releasing the navel makes it impossible to tighten the skin above it which seems to be much of your problem.  I would insist on a redo understanding that there will be a small vertical scar between the horizontal incision and the new navel where closure of the hole in the abdominal drape where the old navel had previously resided is completed.  This might not have been necessary if a full abdominoplasty were done in the beginning.

 

Don't waste a dime on Thermage.  It doesn't work.

The type of tummy tuck you had was essentially a "mini." This removes only the loose skin in the lower abdomen either without moving the belly button or by "floating" the belly button. If you have excess/loose skin in the upper abdomen, a traditional abdominoplasty is more appropriate to address that skin.

A misconception about the belly button: It is not actually "created." It is your belly button, attached to your abdomen, but brought through a small incision in the skin flap that is pulled down. Also, in reference to using Thermage - I agree with your assessment.

Most of the time when only the lower abdomen is addressed, it is at the request of the patient for a shorter scar (a "mini" tummy tuck) - but your scar looks full length, so I would have expected full undermining and transposition of the belly button.  First off, no bridges have been burnt (unless the belly button was "floated" down, but it seems that you have loose skin above it in the pictures), so you could undergo a full revision.  Either you do not have enough skin to fully remove the old belly button, or your surgeon is not that experienced with abdominoplasty operations and was nervous about pulling the skin taught.  (Do you smoke? - this could play a role in the decision making process.)  It is not unreasonable to seek a second opinion from a board certified plastic surgeon who frequently performs abdominoplasty operations.  Either you will find a solution to your concerns, or possibly more understanding as to why your surgeon made the intraoperative decisions he or she performed.

Dr.B

Tummy tucks are an extremely popular and effective way to contour the abdomen. During our tummy tucks, we create a brand-new bellybutton for the patients. The bellybutton, in fact does not move but the skin surrounding it will move down. If you don't like the appearance of your bellybutton after your tummy tuck, there are multiple things that can be done. A scar revision is possible. An umbilicoplasty where we reorganize the skin around the bellybutton may help as well. If you have enough looseness in your lower abdomen, the flap may be lowered once again and a brand-new bellybutton can be constructed.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

What a patient starts out with anatomically and what a patient is willing to accept will produce a variability with the surgical approach. There are a number of variations betwen liposuction alone with or without skin tightening modalities like Thermage or Titan, to mini-abdominoplasties that do not affect the belly button, to modified abdominoplasties that move the belly button lower without a scar around the belly button, to a full abdominoplasty with scars around the belly button that may or may not move the position of the belly button. Add to this the experience, preference, and aesthetic sensitivity of a surgeon and there can be a high degree of variability with abdominoplasties.
With patients who have residual laxity of skin above the belly button, a number of pssibilities exist. It extreme cases, a reverse abdominplasty may be indicated where the scars are placed uner the breast in the inframammary fold and the skin is pulled up. A secondary abdominoplasty can be performed by converting a mini- or modified abdominoplasty to a full abdominopasty but this must be done cautiously in the event that a previous modified abdominoplasty had detached the belly button from the deep tissues since one can lose the belly button itself. If you do not have enough loose tissue to stretch to your low existing scar, or you do not accept a higher second scar (even if it is possible), you might still be able to have a full abdominoplasty with a small vertical scar in the midline above the pubis where the belly button has been "cored" out. Discuss all these options with your surgeon.
In general, I would caution about comparing yourself to other patients whose anatomy, goals, and risk factors might be different from yours.

From your photos it appears that you may have had a mini-tummy tuck which does not address the upper abdomen and many times there is no scar around the belly button because it is "floated" downward and reattached. I would discuss your concern with your surgeon and you many need a full tummy tuck if one has not already been performed.