I am a 40 year old female who had two children in the last 4 years. I was and still am a size 0/2. I always had loose skin (due to yoyo dieting in my 20s), and it got really bad after my two pregnancies in my late 30s. I had a TT done, along with a hysterectomy and breast lift. I am disappointed with the TT. First of all, my doctor did not create a new belly button. Has anyone heard of this before? He said I did not have enough skin, so he just moved it done about 2 inches. I still have loose skin,and it is mainly in the upper abdomen. My PS said that he would have had to have my scar super high to get rid of all loose skin. I will say that my scar is really low in my pubic area. All the pics I have seen of TT, the skin is super taut and the stomach is flat; in every single one the belly button is recreated, and NO loose skin. I have lots of it still....and I am nowhere near being comfy in a bathing suit, like I wanted. If I had known my skin would still be loose, I would not have had the TT done. I guess what I am asking is... have any you PS heard of a TT being done without moving the belly button? My belly button sits low, and I still have loose skin. Is there anyway to correct this? My PS is recommending Thermage, and I think THAT is a joke. I am 7 weeks post op.
Belly Button After Tummy Tuck Surgery: Can It Be Moved?
Doctor Answers 12
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.
Placement of Belly Button After Tummy Tuck Surgery
The picture is not appearing and without examining you, it is hard to say for certain. Likely you did not have enough skin to need to re-create the belly button and he performed a mini tummy tuck, where the belly button is "floated" and pulled down with the skin. A mini or standard tummy tuck generally does not address the very top part of the abdomen, but for patients who did not have a ton of excessive skin on the upper abdomen, a mini or standard tummy tuck is sufficient. To address concerns with significant excess skin on the upper abdomen, an incision is made along the center of the abdomen, which can leave a pretty significant scar, but it does not sound like this would describe you. Typically that type of tummy tuck is performed on massive weight loss patients. Because you may not have had enough "looseness", it is likely that he was not able to address your concerns completely without creating a higher incision. I would visit your original surgeon and discuss this with him and see what he recommends as the best solution to correct your concerns. I would also visit several other board certified plastic surgeons for a second opinion.
Moving a bellybutton after a tummy tuck
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.
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High degree of variability with abdominoplasty
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.
You probably had a mini tummy tuck
The only way I know to have a tummy tuck and not have a scar around the belly button is either to have had just a mini tummy tuck or one with a "floating" belly button in which the belly button is lifted up with the skin and pulled lower down the abdominal wall. It's hard to tell from your photo but is seems that you still have excess skin in the upper abdomen. Probably it would be best to express your concerns with your doctor and see what options are offered to you.
Tummy tucks- hybrid procedures
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.
Part Mini and Part Full tummy tuck does not completely correct all loose skin
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.
Thermage is never a substitue for a tummy tuck (abdominopasty).
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.
Belly button position and tummy tucks
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.
Mini tummy tuck vs. Full tummy tuck
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.
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