How Can my Belly Button Be Made Smaller and More Attractive? And How Can my Breasts Be Made More Symmetric? (photo)

Although your history and post-operative pictures are
helpful, it’s difficult to make a specific recommendation without performing a physical
examination. Review of your post-operative pictures suggests several areas of
concern.These include breast asymmetry
and distortion of your umbilicus.It’s
important to wait at least six months before undertaking revisional
surgery.This will provide time for
adequate healing and resolution of muscle spasm and swelling. At this point,
the situation will be stabilized and the surgeon won’t be trying to hit a moving
target.There’s
no question that the right breast implant sits higher than the left implant,
but the cause of this deformity is unclear.It may be related to sutures placed in the inferior pocket, capsular
contracture, inadequate pocket dissection or spasm of the pectoralis
muscle.If it’s still present six months
following surgery, additional surgery will be necessary.Surgery will most likely require expansion of
the right inferior breast pocket.It’s
also important to note that the left nipple areola sits lower than the right
nipple areola complex.This deformity
may also need to be addressed if the goal is symmetry.This may require a unilateral breast lift
procedure.Pictures
of your umbilicus suggest a separation of the superior portion of the
closure.This can be easily corrected
with a minor procedure under local anesthetic.It’s
important to discuss these issues with your plastic surgeon.After six months, it may be reasonable to
consider revisional surgery.Your
surgeon should be able to formulate a treatment plan if this becomes necessary.

    A circumareolar lift will improve areolar position and symmetry for your breasts.  An umbilicoplasty may be an option.  It is important to realize that the belly button you have probably looked exactly like that prior to tummy tuck.  However, it is not covered or hooded by loose skin.  Having said that, it may be possible to change the shape and contours with some stitches under the belly button to anchor it at several points.

The photo attached seems to show a relatively good sized belly button, and the problems you describe could probably be fixed without making it larger. These types of procedures are typically done under local anesthesia. The breast asymmetry is a bit more complicated. You may need a breast lift on one side.

Thanks for your question and your pic. Without seeing your preoperative picture it is hard to comment on what your outcome is. I do thing the BB can be revised under local in the office. If you think of it as a clock, you could remove from 5-7 o'clock to decrease the area. The diameter is trickier to decrease but would involve removing a "ring" around the top.

Regarding your breasts, I would give it a full 6 months from surgery to know where the implants settled. Not knowing your original shape or the implant size makes it harder to comment on whether or not the outcome is expected. Some revision could likely be done if you were not satisfied but the surgeon must feel confident in giving you the outcome you want. Best of Luck!

Difficult to give you specifics without assessing a pre op photo.  The umbilicus seems to be a relatively simple fix, perhaps in the office under local or with a breast revision if necessary in the OR.  Related to the breasts, again need more facts as one normally does not suture under the breasts in a primary augmentation.  Questions would be difference in implant volumes and differences in nipple height pre-operatively. Lifting one side with a periareolar lift would address nipple height but not implant height.  Need face to face exam with another surgeon to work out options here.

Yes revision of the bb can be done under local anesthesia. As for the breasts issues only revisional surgery as in a left donut lift, re positioning of implant on right, act can help. 

Hello,

Thank you for the photos and the question.  Your breast size and shape can be repaired with a revision.  Since you are 3 months after your surgery it will be important to determine if you are continuing to see changes in your breast shape. Since it sounds like your plastic surgeon sutured the pockets (capsulloraphy) the repair may soften with time and if your breasts are still changing additional time should be taken.  If your breasts are no longer changing than a revision will be needed to make the breast implant pockets more symmetric.  In terms of your belly button, you have two options.  The first is to do a belly button reconstruction that often requires two stages to accomplish the best result.  The second option is to re-do the tummy tuck pulling down further on the abdominal skin resulting in your current belly button location being closed as a vertical incision and a new belly button created.  This second option is more involved in terms of cost and downtime and it also would benefit from waiting longer as more abdominal skin relaxation will occur.

All the best,

Dr Remus Repta

Before commenting upon the individual items (breast and navel) I am wondering if you have scoliosis. Obviously I cannot see the back on this photo, but I do see an "s" curve as I follow the line between the breasts and follow along the "midline of the upper abdomen, and this is typical of scoliosis.

As far as the navel goes, it does appear to be in the midline, though the landmarks are not all visible on the photo. A minor revision could remove some of the skin within the navel. A pursestring suture might narrow the navel some.

As to the breast, it would be useful to see pre-op photos. One nipple is lower now, and I cannot tell if it was like that before surgery. The implants is lower on that side, and it may be that the entire breast is lower, again without pre-op photos, I cannot tell. Yes, the asymmetry can be improved, but how would depend on looking at such photos, and upon an examination.

Thanks, best wishes.

The revision of your Belly Button, called Umbilicoplasty can be done simply under local anesthesia in the office.

Since the surgeon used internal sutures to lift your breasts my guess is the right one is being held higher by these stitches. If this is so, then your surgeon may be able to release the stitches and allow the implant to drop into a lower position to match the left breast.

Discuss this with your surgeon.