Candidate for floating belly button after pregnancy
In general I am not a fan of the float procedure, not because it doesn't work for the right patients, and not because I don't like to do them, but because it is often used on the wrong patients with disastrous results. By that I mean that some women get the procedure when they really should have a formal umbilicoplasty and accept the small vertical scar if necessary. It is often very difficult to predict just how much excursion, or downward movement, of the abdominal skin we will see, and in my experience it usually winds up being a bit more than we predicted. In such cases the belly button would wind up too low, or the upper abdominal skin would have to be left too loose. In either case the results are unsatisfactory in my opinion. If there is any question at all about how much excursion the upper abdominal tissues or belly button will get, it is usually best to just do formal umbilicoplasty and deal with the very small vertical scar if necessary. Many times it is not even an issue after all. When the umbilicus is placed too low, it is just about impossible to correct.
Thank you for the question and pictures. Given your stated goals, I think it is likely you will do best with a standard tummy tuck operation. You are right in that a vertical scar may be necessary in order to keep the tummy tuck incision low.
I have also attached some advice that I provide to my patients who are about to go tummy tuck surgery:
1. Make sure you are doing the procedure for the right reasons (for yourself) and that you have realistic expectations. Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life situation. You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.
2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.
3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.
4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.
5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina of your caretakers.
6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.
7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.
8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).
9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the emotional swings that you may experience.
10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.
11. Keep in mind the end results as you go through the tougher emotional times after your surgery.
I hope this helps.
This particular question is difficult to answer based on photos alone, since it takes an in person exam to evaluate the amount of laxity present in the skin.
I do feel that if tightness your #1 objective, you should go with the vertical scar, since there will not be a limitation on amount removed based on navel position. With a float technique, you are limited in how much you can tighten the upper abdomen before the navel might be placed unacceptably low.
All the best.
Following the advice from a surgeon or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.
Having stated that, given your goal of tightening your stomach as much as possible and never having to redo the procedure, a standard tummy tuck with a possible small vertical scar for closure of the prior belly button hole would most likely be your best option. A modified abdominoplasty with a floating of the umbilicus can produce a very nice significant result in many patients. The result depends on the extent of looseness of your tissue above the umbilicus, since there is a limitation of how much tightness you can get with that procedure and still maintain a normal appearing position of the navel.
Robert Singer, MD FACS
La Jolla, California
You can easily have a full tummy tuck done without a vertical scar and that is what I would recommend in your case. Unfortunately, there will be a scar around your umbilicus, bit it will give you a flat tummy and is the best choice.
It appears that muscle tightening will significantly help flatten your tummy. You display some lax skin, but as you have noted, there is a good possibility of a vertical scar. I rarely do the float procedure as the right candidate is sometimes difficult to match to the procedure. Once committed, movement of the belly button downward must be done cautiously. I would suggest a 2nd and 3rd opinion by other Board Certified Plastic Surgeons before you decide. You seem to be realistic about the trade off of the scar and I think other opinions will help you to choose the best approach. I hope this information is helpful.
The floating TT is a very risky operation in take your bb might be taken to low. I recommend you consider a full TT with a vertical scar inferior of the old bb.
Standard Tummy Tuck vs. Floating Belly Button Abdominoplasty
Although a floating belly button abdominoplasty is a reasonable option in patients who don't have a lot of vertical skin excess; from your photos, I believe you would probably have a better overall result with a standard tummy tuck. You are correct that if you want the horizontal scar placed as low as possible it may require an additional vertical scar. But, this tradeoff may well be worthwhile. Best wishes.
Sometimes when I see a patient, I have them sit on the table and we look at their tummy together. Sometimes people complain about how their tummy looks when sitting but also they also mention that the extra tissue makes their clothing feel tight and uncomfortable. If I see significant roll on their upper and lower abdomen then they may be a candidate for a full tummy tuck and not the umbilical float (or a mini). But it is always best to consult a board certified plastic surgeon for a formal consult. Good luck!
Consider a standard abdominoplasty vs a limited approach float procedure with limited results
If you are considering a limited procedure you need to understand that the results can also be limited. An umbilical float procedure can be beneficial for a minor excess of skin above the umbilicus. From your photo is appears that you would more than likely not be satisfied with this limited approach. A standard abdominoplasty will give you the most aesthetically pleasing result.