Umbilicoplasty for Removing Excess Skin Above Belly Button?
I agree with your plastic surgeon that a full tummy tuck would have been the most straight forward way to reshape your belly button. You could undergo an umbilicoplasty in order to remove some of the excess skin above your belly button, but converting to a full tummy tuck may be the best option.
A Secondary Abdominoplasty May Be Needed to Correct Your Excess Skin
The abdomen will often have significant changes following pregnancy. These include saggy, redundant skin, weakened muscles, and stretch marks. Treatment varies and needs to be individualized based on the deformity encountered. Careful analysis of the anatomic deformity is essential to obtaining an aesthetically attractive result.
In the absence of a thorough physical examination, your picture and comments suggest that you have a residual deformity, which primarily involves the area above the belly button.
Conversion of your mini abdominoplasty to a full abdominoplasty may be necessary to correct your problem. A small, vertical incision may be necessary if there is insufficient laxity of the upper abdominal skin to allow transverse closure of the wound. Utilizing this approach, it’s possible to correct these types of problems with secondary abdominoplasty.
Extra Skin by Belly Button Correction
Belly Button surgery also called an umbilicoplasty, by itself only takes care of stretch marks and loose skin in the immediate area (few inches) of the belly button. It might be a good procedure for you but an exam would be required to confirm this impression. Choose the best plastic surgeon with the most experience (see below link).
Tummy Tuck Would Serve You Best
Unfortunately, the best treatment for removing excess
skin above the bellybutton would be to convert you to a full tummy tuck.
After pregnancy, the skin around the bellybutton is
often stretched, creating permanent stretch marks and thinning the skin.You would very likely have a less desirable
appearance if an attempt was made to simply remove the excess skin and close
During the performance of a full tummy tuck the skin
and fat layer is lifted off of the underlying muscle layer until the
bellybutton is reached.At this point,
an incision is made around the bellybutton allowing the skin and fat layer to
continue to be lifted and released from the underlying muscle layer.This is continued until the rib cage is
encountered.At this point, the skin and
fat layer is pulled snugly downward.This will more uniformly tighten up the skin above the bellybutton.Once the excess skin is removed, the belly
button is brought out through a new opening.This allows for a more cosmetically appealing bellybutton.
Peri-umbilical Incision Tummy Tuck are possible
There are abdomenoplasty, or tummy tuck techniques that excise skin around the belly button or umbilicus alone.
Peri-umbilical tummy tucks have not become very popular due to concerns about the resultant scar, and limitations on the amount of skin that can be removed.
Most often you will need a full tummy tuck to correct significant skin excess. I suggest that you seek a second opinion consultation with a board certified plastic surgeon who can examine you and discuss the options to address your concerns.
Definition of Reverse Upper Tummy Tuck
Not infrequently I see patients in whom there is as much skin laxity in the upper abdomen as there is in the lower abdomen. In fact, some patients after pregnancy will have fairly 'toned' lower abdominal skin, but very lax and redundant upper abdominal skin. In these situations, the removal of skin in a vertically downward direction ( a conventional tummy tuck) is not adequate to correct the upper abdominal skin laxity. Such patients are often very good candidates for what I refer to as a 'reverse upper' abdominoplasty.
This surgical technique involves removing excess abdominal skin vertically upwards using incisions hidden in the inframammary folds underneath the breasts. THERE IS NO INCISION MADE BETWEEN THE BREASTS. In general, this operation is best reserved for patients with fairly full or at least slightly droopy breasts, which serve to nicely conceal the inframammary folds. An important part of this procedure is the placement of permanent lifting sutures that elevate the lower skin edge, following removal of excess skin, to the upper skin edge in the inframammary fold. These permanent sutures ensure that the resulting surgical scar remains hidden within the inframammary fold.
A great advantage of this procedure is that the patient's original belly button is preserved, and thus there are absolutely no surgical scars that are visible when wearing a two-piece swimsuit or typical underwear (bra and panties). Additionally, because this procedure generally requires less skin undermining and thus less interruption of the normal blood supply of abdominal skin, more thorough liposuction of the waist and back can be performed at the same time.
Many patients having this surgery, therefore, undergo a reverse upper abdominoplasty combined with a lower 'mini' abdominoplasty, tightening of the entire length of the rectus abdominis muscles, and liposuction of the circumferential trunk - and keep the belly button with which they were born. I usually refer to this operation as 'reverse upper / modified lower abdominoplasty'.
An isolated umbilicoplasty will not solve your problem.
The treatment of choice was and remains a 'full' abdominoplasty which includes the umbilicoplasty.
Umbilicoplasty is not the answer for loose skin above the belly button
Umbilicoplasty is not the answer following mini tummy tuck. Unfortunately, the skin above the belly button has not been properly redraped nor has the belly button been properly recontoured. Only a formal abdominoplasty will accomplish both. For those with isolated excess periumbilical skin (uncommon condition), an umbilicoplasty can be helpful.
Umbilicoplasty to correct excess laxity after mini tummy tuck
I believe the question has been answered well. The picture is very helpful. Sorry to repeat that you should have had a full tummy tuck for the best result. Umbilicoplasty can work but only for very minor revisions. Unfortunately, I don't think you would have a very nice result. I wish to add that less than 1% of tummy tuck candidates are really appropriate for mini tummy tucks in my experience. Even those with similar body builds and less skin laxity than yourself in whom I was almost sure were going to get a mini tummy tuck ended up getting a maxi through a mini incision with much nicer results. One cannot get a maxi result through a mini incision. The idea is to cut and stretch the "bad skin." A lot of bad skin means a longer incision, more dissection, or both.
Correcting the loose skin after a mini tummy tuck
The ideal candidate for a Mini Tummy Tuck is an individual who has:
1. Good skin elasticity with minimal looseness
2. No or minimal stretch marks
3. A belly button high above the bikini line
4. Thin with a long waist
I have had good results with Mini Tummy Tucks, but I see very few women in my practice who are good candidates for this procedure. At issue is the fact that Mini Tummy Tucks do not tighten the skin very much. The flattening of the abdomen with a Mini Tummy Tuck results from liposuction and tightening the muscles. The scar is shorter because less skin is removed during a Mini Tummy Tuck than during a Tull Tummy Tuck.
Based on the photo you have submitted, I think that you would have a very nice result with a Full Tummy Tuck. An Umbilicoplasty will not provide you with the improvement you are looking for.
I would recommend discussing your concerns with your Plastic Surgeon.
Andrew Lyos, MD, FACS