Umbilical Float TT - Said I have too much skin for it? (photos)

Hello and thank you for your question regarding the umbilical float technique. Thank you for your history and your picture.

During an umbilical float procedure, the umbilicus is detached from the underlying abdominal surface, and the abdominal skin and fat are pulled down. Usually, the umbilical float technique is reserved for patients with a minimal amount of excess abdominal skin. Your plastic surgeon is indeed correct. You have too much lower abdominal skin to have an umbilical float procedure. If you underwent an umbilical float procedure, your belly button would be in a completely unnatural position. Your floated belly button would be too low, approximately 1 cm above your tummy tuck scar. This would not be aesthetically pleasing.

Most experienced plastic surgeons would agree that there is minimal risk of needing the vertical incision where your prior belly button was previously located. Most plastic surgeons should be confident that they can remove the excess skin from the lower abdominoplasty or tummy tuck incision to well above your belly button.

Please watch videos on YouTube regarding the standard tummy tuck. Also, watch videos on YouTube regarding the umbilical float procedure. In conclusion, most plastic surgeons would agree that you should not undergo the umbilical float procedure due to the amount of lower tummy skin you have. Additionally, I would not worry about the vertical scar from the belly button. First, I don’t think it will occur; second, if it does occur, the vertical scar heals very well and is barely noticeable.

Good luck with your tummy tuck. I think you will achieve excellent results without the umbilical float technique. I hope I’ve answered your question regarding the best approach for your tummy tuck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Hi, thank you for sharing your question. You are likely a candidate for either option and ultimately you will have to decide based on the risks and benefits of each after a detailed discussion with your surgeon.

It turns out that neither an umbilical float nor a short vertical scar are necessary. I always avoid them. But there are tricks the surgeons needs to know to do this. One is to maximally flex the operating table in surgery, as much as 90 degrees. This way all the excess skin may be removed, the umbilicus preserved (brought through a new opening), and no vertical scar. A vertical scar is unattractive on the lower abdomen. It is important for the surgeon to know how to keep the scar low and avoid a vertical scar in all cases. You may be stooped over for a week or two, but the results are worth it.

Thank you for your inquiry! During a Tummy Tuck, the abdominal muscles are tightened, fat is liposuctioned, the mons is lifted, and the excess abdominal skin is removed at the low incision. When the skin is pulled down, so is the belly button. With an umbilical float, the belly button would be so close to your waist line, at your pant line. Schedule a consult with a Board Certified Plastic Surgeon to help you meet your goals.

It all depends what is bothering you: the scar or the shape. I agree with your doctor about the possibility of a small vertical scar in the lower abdomen to give you the best shape possible. But if you don't let your doctor do what is necessary for a best shape, then not enough skin can be pulled down since your umbilicus will theater the upper abdominal skin. An umbilical float is always a bad idea since the umbilicus will end up in some unnatural position.

Dear brittanys09,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

This is a situation where an in-person consultation is crucial, as it allows the surgeon to thoroughly evaluate your abdominal skin and discuss all available options. Based on the photos, it appears that you have enough skin and sufficient laxity for a full tummy tuck. The horizontal incision would be placed low, without the need for a vertical incision.

Vertical incisions can be avoided by using sequential tension sutures. This technique stretches and anchors the abdominal skin to the deeper tissue during the tummy tuck, preventing the final horizontal scar from being pulled up as you heal. An added benefit of this method is that you would not need drains after surgery.

Dr. B.

Thank you for your question,You have a tall body, and especially there is excess skin under the navel. It is important to examine patients leaning forward to see if there is enough skin. It is not enough to see from your photos to see if you have excess skin over the belly buton. When tummy tuck and liposuction are combined, the skin over the belly button will be lose and it will be easy to close the defect. Floating TT will cause the belly button to be in a lower position and it will very close to pubic area.

Umbilical float surgery is the perhaps the worst abdominal surgery to be performed. It never tightens the upper abdominal skin enough and the belly button is always too low on the abdomen. Here's what you need to know: a properly placed, very, very low long incision that skirts along the border between thigh and abdomen laterally and between pubis and abdomen centrally is the place where it will become completely inconspicuous in a short time. Placement of the incision there is far better than one placed higher. The trade off is a SMALL vertical scar low in the abdomen that isn't even noticeable in public when wearing a bikini. When a surgeon tells you there 'isn't enough skin for a full TT', run. Small vertical scars were once (and still frowned upon by many in my field), but there is a rising tide of surgeons who know its that best way to get the best belly for so many women. Check out photos on social media.

In one photo, it appears like you will have no problem having a full tummy tuck. In another photo, it appears the skin is quite tight. What will mostly happen at the time of surgery is the surgeon can make the top incision first and pull down as much as possible. This way you can end up with the umbilicus without the umbilical float and have the scar slightly higher, that can be revised later if desired.

Best Wishes,

Gary Horndeski, M.D.