Necrosis of Belly Button Stock, What can I do Now?

Question

I have had necrosis of BB since 2 day post op, now on week 3 post op my Dr said it appears the entire stock is dead! I am not a smoker. I am 37 years old very physically fit. I am an exercise physiologist and take great care of my body. it was three kids and 2 c sections that ruined my stomach! I do not understand why this has happened. My Dr. Is great and seems very shocked! How does this happen? Options to fix? Will it ever look normal? How long will it take? What is the best way to fix?

Tom J. Pousti, MD · Answer

I'm sorry to hear about the complication you have experience.

	At this point, it would be in your best interests to avoid surgical intervention if at all possible. Allow the body/umbilical area to heal and evaluate the &ldquo;end results&rdquo; somewhere between 6 months to one year after surgery. At that point,  options for treatment will depend on exactly what the area looks like. Options may include allowing for further time to allow scar maturation to umbilical reconstruction.

	In the meantime, I would suggest that you continue to follow-up with your plastic surgeon  and try to be as patient as possible.

	Best wishes.

Michael Law, MD · Answer

Most plastic surgeons use permanent sutures to tighten the abdominal wall, and some of those sutures are immediately adjacent to your new umbilicus.  Umbilical stalk skin necrosis means that the barrier between these permanent sutures and the outside world may be breached, creating the possibility of internal suture infection. Antibacterial ointment will not only reduce the likelihood of an infection, but will also promote the healing of the umbilical stalk if some of the stalk is still viable (i.e. it has enough blood flow to survive). The blood flow to the umbilical stalk and the blood flow to the abdominoplasty skin flap are completely different.  So umbilical stalk necrosis does not mean you are at high risk for abdominoplasty skin flap necrosis.  If the skin of your lower abdomen just above your suprapubic abdominoplasty scar is pink and you are ten to fourteen days postop, then there is no need to worry about skin flap necrosis. The best course of action is local wound care as mentioned above and frequent visits to your plastic surgeon.  Regarding the long–term appearance of your new umbilicus: the sutures through the skin adjacent to your belly button will create permanent suture marks if they are not removed soon.  Ask your surgeon if that can be done in order to avoid a pattern of dot-like scars around your new umbilicus which will make it look like a surgicalbelly button, not a natural belly button.  It is possible to place umbilical skin sutures so that they pass through the dermis only (and not the epidermis) on the abdominoplasty skin flap side of the umbilical closure. You may ultimately require some form of revisional surgery once the belly button wound has healed, but in most cases a definitive secondary procedure cannot be done for at least  6 months or so.  So you will need to be patient, take good care of the wound, and see your doctor frequently as this issue evolves.

Tracy Kayan, MD · Answer

Hi - Very sorry to hear about your belly button. While this is not a common occurrence (the most common area to have necrosis is in the skin between your belly button and pubic area), the belly button is surprisingly forgiving in terms of healing. For now, I would just make sure you take care of the wound to prevent infection, but otherwise I would advise waiting to see how everything heals up. If you are unhappy with the eventual appearance (we are talking after AT LEAST 6 months), a revision can be done, or a new belly button created. For now, just be patient and take good care of the wound.

Ronald V. DeMars, MD (Retired) · Answer

I'm sorry to hear that you are having this problem. It is not a common occurence and I doubt you can ever pinpoint exactly why it happened. I think it would be a very big mistake to get too aggressive with any surgical intervention at this time. Commonly, when there is soft tissue loss it is best to refrain from any surgical repair until the area has completely healed. We are sometimes surprised at how little further work is necessary if we are just patient. Follow your doctor's advice carefully as far as the wound care.

Necrosis of Belly Button Stock, What can I do Now?

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Answer: Necrosis of Belly Button Stock, What can I do Now?

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Necrosis of Belly Button Stock, What can I do Now?

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Answer: Necrosis of Belly Button Stock, What can I do Now?

Answer: Necrosis of Belly Button Stock, What can I do Now?

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