How Do Plastic Surgeons Determine Belly Button Placement when Performing TT?

The correct anatomic position of the umbilicus (belly button) is at the level of the posterior iliac crest in the midline.  A belly button should be lightly longer than it is wide, tall and narrow. This makes the waist look smaller. I hope this helps.

By most techniques, the navel remains attached to the abdominal wall during the performance of the surgery. Once the excess tissue has been removed, and the upper abdominal tissue pulled down to reach the horizontal incision, a mark is made to note the level of the navel, and an incision is made there through which the navel is sutured into place.

 

Occasionally and under special circumstances,  a technique called "umbilical float: is used. Here the navel stays attached to the abdominal skin and may be moved down several centimeters. This requires the patient's foreknowledge, and can work well if the navel is higher than desired.

Thanks for the question, best wishes.

The belly button position is very similar to where it was prior to surgery because it stays connected to the underlying tissue.  It will look longer and more beautiful ideally after surgery because of the removal of extra tissue but really should not be moved more than a few millimeters up or down from its original position.

The belly button (or umbilicus) is never detached from its fascial blood supply when I perform a tummy tuck (abdominoplasty).  Although it appears sometimes to be lower or off to the side before the procedure, that is just merely the stalk and surrounding skin.

 

Once this excess is removed, I place it back anatomically into the midline and a new hole is cut out to inset around the belly button, virtually making it appear without a visible scar.

Classically there are two anatomic landmarks for positioning belly buttons with tummy tucks, one is the midline and the other is a line drawn with the superior iliac crests. 

The crests are the two bony prominences you can feel on the front of your pelvic bones. 

This seems straightforward, but actually it is many times not that straightforward as the pelvis can be tilted to one side or the other. In fact pelvic tilt is more common than not. 

 

Also many people have lopsided bodies due to one side being wider than another. Just look at your natural belly button and realize it may not be in the exact middle now!

So I place the belly button at the level it is currently, ie...I place it where God put it and I try to place it as close to the midline as possible. 

Fnally I relate all of these facts to my patients to give them realistic expectations, which should be a belly button as close to the middle as possible at or near the level it was before the surgery.