Why Do Some People Lose Their Belly Button During Abdominoplasty?

Hi there-

It is possible that the belly button may lose its blood supply during the procedure, or that the surgeon chose to remove the belly button in order to complete the operation.

Both of these circumstances should be quite rare.

The belly button is a natural scar that is the result of clamping off your umbilical cord at birth. It primarily consists of several blood vessels that clot and scar once the clamp is placed. Therefore the blood supply is compromised. When performing a tummy tuck the blood supply is further limited by a incising all the way around the umbilical stalk. It commonly heals poorly due to this blood supply and in very thin individuals the stalk may be small, absent, or extremely shallow. When the remaining abdominal skin is pulled tight around the belly button, this can further make it appear less deep and therefore less noticeable. Healing commonly produces a small, superficial belly button which is less prominent than the original deep and wrinkled umbilicus.

A full abdominoplasty requires the surgical creation of a new belly button. Creating the new belly button, which is called an umbilicoplasty, is a part of tummy tuck surgery that requires a great deal of attention and finesse on the part of the surgeon. My goal is to create a new belly button that, as much as possible, resembles a 'natural' belly button. Natural belly buttons do NOT look like a perfect circle, and circular umbilicoplasty scars are a tummy tuck dead giveaway.

The technique I use for umbilicoplasty is designed to create a slightly 'hooded' appearance to the upper half of the belly button, an appearance that is generally considered fit and athletic. Not all patients have the goal of wearing a two-piece swimsuit, but many do, and I want these patients to be able to do so without feeling self-conscious about the appearance of their new belly button.

This can happen.  Certainly it is more common with extremely long thin umbilical stalks asscoaited with the morbidly obese.  Also those pateints who have had multiple hernia repairs are at high risk for complications with the umbilical stalk during abdominoplasty prcedures.

When you do a tummy tuck the tissue around the belly button is tightened as part of the muscle wall plication. The amount of tightening is a judgement issue of trying to get the best results. The time I have seen the most risk to the belly button is when a hernia in the belly button needs to be repaired at the time of the tummy tuck.
Any experienced surgeon will tell you there is a risk of belly button loss, however, even if the original belly button dies a similar structure can be created.
Best Wishes.

Loss of a belly button during a tummy tuck would be extremely rare, it may be slight in patients with very large abdomens that hang a lot. Poor technique would be one reason but it should not routinely happen.

There are two explanations.  One is that the blood supply was lost and the navel simply died.  The second is that the surgeon chose to remove the navel for technical reasons.

Most resultant umbilical loss is due to poor surgical technique. Harming the blood supply to the belly button causing necrosis or death of the area.
From MIAMI Dr. B

The belly button is the scarred remnant of the entry site of the umbilical cord. It has a dual blood supply: through the skin and on its walls from the abdominal wall musculature. Anything which disrupts this flow could cause in compromise of the belly button.
Since in Tummy Tuck surgery the belly button is circumscribed and cut, the only blood supply remaining is that along the umbilicus walls. Prior hernia repairs or laparoscopic surgery could have weakened this supply so ones the skin incision is made and the skin supply is gone away, the belly button's own supply becomes inadequate resulting loss of the belly button.