Tummy tuck vertical incision to remove old belly button? (Photo)

Usually there is enough skin to remove the old bellybutton keyhole although sometimes it is tight and you have to recovery for 1 week not fully straight and walking a bit bent over. Do you have prior scarring or surgery that would limit the skin stretch?

Thank you for your questions and photos. From your photos, it appears that you would have enough skin and are good candidate for a tummy tuck (scar below bikini line) with 360 liposuction. A tummy tuck will address excess skin & repair of the abdominal muscle. The abdominal wall can be weakened after pregnancy and (or) significant weight gain & loss. By repairing the muscle, not only does the appearance of your abdominal area improve, but your core strength as well. The repair of the muscle will cinch your waist like an inner corset, lift your pubic mons area and accentuate your curves. Liposuction will remove excess fat from unwanted areas with some skin retraction. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon

South Barrington
Oakbrook Terrace
Orland Park

Hi Firstkitty,

Thank you for your question regarding whether you should undergo a tummy tuck with a vertical incision to remove your old belly button. Thank you for your history and your pictures. The main purpose of a tummy tuck is to fix the abdomen. I would ask you specifically what bothers you about your abdomen. Once you have an objective idea of areas you want to address, then your tummy tuck can be individualized or personalized for your maximum benefit. Also, why are you looking to remove your old belly button? In analyzing your pictures, you have mild to moderate abdominal skin excess, mild to moderate abdominal fat, and moderate rectus abdominis weakness, especially below the belly button. Also, you have excess skin and fat on your lateral torso (from under the bra to the top of your hips).

Why not just do a standard horizontal tummy tuck? This would include an incision low in the groin and higher over the hips. Tissue dissection would be done to the sternum, and the rectus abdominis muscle would be repaired and plicated. Your excess abdominal skin would be pulled flat. Most plastic surgeons would agree that a horizontal tummy tuck would achieve the best results for your tummy.

You do not have much vertical excess of your abdomen. Most plastic surgeons would not suggest a vertical abdominoplasty. The vertical tummy tuck leaves a highly visual scar and is very difficult to conceal. Most plastic surgeons would agree that much more skin can be eliminated with your horizontal tummy tuck compared to the vertical incision you are describing.

Another alternative for your central abdomen (especially for the skin and fat on your side, which hangs from just below the bra strap to the top of the hips) is called an hourglassing procedure. Some plastic surgeons call the hourglassing procedure a vertical torsoplasty. During the hourglassing or vertical torsoplasty procedure, an incision is made from underneath your armpit (or in your case just underneath the bra) and is extended to the hip. During the vertical torsoplasty, a large ellipse of skin and fat is removed from your sides. The vertical torsoplasty does several things. The procedure eliminates excess skin and fat from your sides. The vertical torsoplasty pulls the tummy laterally and flattens the abdomen. Also, the vertical torsoplasty creates an hourglass body shape. The only thing the vertical torsoplasty or hourglassing procedure does not accomplish is the tightening of the rectus abdominis muscle. Most plastic surgeons would agree that muscle plication is a very important part of your reconstruction.

Therefore, most plastic surgeons would suggest a horizontal abdominoplasty with muscle repair. If you have already had the horizontal abdominoplasty with muscle repair, then most plastic surgeons would suggest the vertical torsoplasty with an incision just underneath your bra strap to the top of your hips.

I hope I have answered your questions regarding a vertical incision tummy tuck to remove an old belly button. Good luck.

Sincerely,
Dr. Katzen

Hello and thank you for your question. From the pictures you have provided, you should be proud of your body, especially at 70! You have a moderate amount of excess skin and subcutaneous fat present throughout your trunk- most notable in your lower to mid central abdomen, minimal excess in your flanks, and excess skin throughout your mid & upper back w/ notable asymmetry (more fat excess and skin excess on your left flank and back compared to the right). Based on all this, you would benefit from an abdominoplasty (tummy tuck) to help improve your abdominal/trunk contour. As your surgeon has already mentioned, because you do not have a severe amount of skin and fat excess in your lower and mid central abdomen, there is less tissue to resect during the operation, meaning there is a possibility you might have a residual vertical scar (from the cutout of your current belly button), which may or may not be connected to the main horizontal tummy tuck scar. Of course, we surgeons always try to remove enough skin in the operating room to prevent this vertical scar, if it is safe to do so. Some people pull things tighter than others, but the downside of pulling things too tight and resecting too much skin during this procedure is there can be too much tension on the horizontal wound- meaning they might not be able to get things closed in the operating room, or if they do, the wound will be under too much tension which can significantly increase the risk of wound healing complications (wound breakdown, dehiscence, infection, widened or unattractive scars). Weighing these potential risks against the risk of a small vertical scar which almost always heals uneventfully and is minimally noticeable, I'm sure you'd agree that the small vertical scar is worth it. Regarding the transverse lower abdominal scar and even the vertical scar, if you adhere to proper scar care and sun avoidance after surgery, they should eventually heal to be minimally noticeable. And depending on how close the vertical scar is to the horizontal scar, it can always be removed at a later time (6-12 months later) in the office under local, if this is truly a concern.
Regarding floating your umbilicus (belly button) or even a mini-abdominoplasty- these are sometimes reasonable options, but generally only in patients that have a notably long torso and belly button which is positioned higher than normal, as otherwise they make the belly button look too low which looks very weird. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

It appears you have a lot of excess skin, even on your sides and back. You may benefit from a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided and nipple sensation (in 95%) is maintained. This technique will also pull up the upper abdominal skin. In your side view, you can see you have a lot of lateral skin as well. At the same time or later, you can undergo a back lift to pull up the back skin. This may take care of the upper abdomen and you might get by with less of a tummy tuck such as a mini tummy tuck for the bottom portion. This would eliminate the need for the vertical scar.

Best Wishes,

Gary Horndeski, M.D.

Your doctor is 100% correct. The alternatives (floating the belly button into malposition or placement of the long transverse incision higher across the abdomen) are aesthetically inferior to a small, midline, vertical scar. The reality is that plastic surgeon training with regards to tummy tucks is, even now, still in the dark ages. The concept of always getting the hole out to avoid an additional scar was always flawed. We have learned this lesson three decades ago with regards to minimizing scar perception in the face, but never applied the principles to the body. While standing naked in the mirror, your eye should see an unobstructed abdominal contour leading down seamlessly to the pubic triangle, which is why a VERY low transverse incision should be made. The short, vertical, midline scar of the remnant hole does not obstruct that view the way a high transverse scar does. When surgeons realized that, instead of closing the hole, they stuck to their guns about not making an additional scar and came up with the floating belly button. This is just as bad for two reasons: malpositioned belly buttons are just as abnormal to the eye, and because surgeons knew that, they limit upper abdominal skin tightening, hence giving your the worst of both worlds: a funny looking abdomen with skin that's still loose. In my practice, 95% of my patients have vertical scars. Go with your doctor!

I don’t think the vertical is that bad of a problem but I prefer it connected to the horizontal scar in order to keep the horizontal scar low enough. I think that can be accomplished in your situation

A tummy tuck, also known as abdominoplasty, typically involves an incision made horizontally across the lower abdomen to remove excess skin and fat. This horizontal incision usually results in a new position for the belly button, which is repositioned to match the tightened abdominal area.A vertical incision is not typically used for a tummy tuck to remove an old belly button. However, in some cases of more extensive abdominoplasty, such as after massive weight loss or in combination with other surgeries, a vertical incision may be used along with the horizontal one. The specific approach and incision pattern depend on the individual’s unique circumstances and the surgeon’s recommendations.If you’re considering a tummy tuck and have concerns about your old belly button, it’s essential to consult with a board-certified plastic surgeon. They can assess your situation, discuss your goals, and recommend the most appropriate surgical plan for your needs.

Ask your surgeon to show you photos of both procedures so you can get an idea of what you may expect.

An in person evaluation is best, but from the photos it appears you have adequate skin laxity for a standard tummy tuck. Sometimes that vertical incision is needed to keep the scar low if the patient doesn't have enough excess skin. It can be located low near the horizontal scar to optimize keeping it hidden. It tends to heal very well. I encourage you to visit with a few board certified plastic surgeons near you for consultations to hear varying opinions.