Thoughts on Neo Umbilicoplasty?

Thank you for your question. A history of multiple umbilical hernia repairs does raise the concern for changing the blood supply after a tummy tuck procedure. With previous procedures, or a simultaneous hernia repair, the concern is that a tummy tuck surgery could cause the belly button belly button to not have enough blood flow and it could die. Neoumbilicoplasty is one way to avoid this problem. A new belly button is created. A neoumbilicoplasty can look very nice in the right person. It's not a good choice for everyone, so discuss your concerns with your plastic surgeon so that you can decide which procedure is right for you.

So you're going to travel to the Dominican Republic from Portland, OR. That has to be a huge trip and is going to put you at high risk of DVT. I can't recommend any patient travel such long distances for surgery that can be performed expertly here in the USA. You will also be at high risk of having belly button necrosis with your history of mesh repair. I would suggest you find a surgeon here.Best wishes, Dr. ALDO 

I have not found that to be necessary in the many surgeries I have performed, but this always remains a possibility.

Dear Trisha_Rae,it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

You will receive the best answers after an examination.  The extent of your previous hernias would need to be considered as well.  The belly button often does very well after the procedure, though it sometimes heals a little slowly.  I would recommend seeking another opinion from a board certified plastic surgeon in your area to help determine what is best for you.

Good question.  Umbilical hernia repairs at the time of tummy tuck do increase the risk of complications of the belly button.  This is called ischemic necrosis.  Fortunately it does not happen often and usually the belly button heals well even if it "struggles" a bit during healing.  The exact location and size of the hernias make a difference in how much risk you have.  It is hard to give precise advice without an in person examination.  

Thank you  for your awesome question! Your bio is very helpful, however without the benefit of knowing your full health history and an in person exam it's impossible to say for certain. 
  I would recommend you have an in person consultation with a plastic surgeon with these credentials: *Board Certified by the American Board of Plastic Surgery -- The gold star symbol
*A member of the ASPS (American Society of Plastic Surgeons) -- The circle symbol
*A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) -- the Queen Nefertitti symbol with a Triangle  *On faculty at local plastic surgery teaching program -- in our office we are affiliated with both Duke and UNC schools of plastic surgery.  I hope this is helpful and wish you all the best in your journey.  My sincere best, Brian S. Coan, MD, FACS

Umbilical hernia repairs sometimes interrupt the blood supply to the umbilicus, but not always. In person examination of your tummy would be needed. Often, with a few maneuvers, the existing belly button can be saved. I reserve creating a new belly button as a last resort for tummy tuck patients - better to try to keep the one you have. See an American Board of Plastic Surgery certified surgeon.

Your umbilicus sounds like quite a challenge since you have had two hernia repairs.  My concern is that the blood supply to the umbilicus will be compromised.  In cases like this, it is sometimes necessary to sacrifice the umbilicus and create a new one either at the time of surgery or some months later.  Every case is different.  I had a lady years ago who had a very large umbilical hernia that basically destroyed her umbilicus.  I did a tummy tuck and fixed her hernia a left her with no umbilicus.  We both thought she would be fine with that but a tummy without an umbilicus looks really, really creepy.  I ended up making a new one for her with some flaps and a little skin graft. 

Some of this depends upon what was done previously in terms of umbilical hernia repairs, incisions/scars, what your belly button looks like now. However, in cases like these where the blood supply through the umbilical stalk may have been interfered with, I perform a "delay" procedure about 2 weeks before the tummy tuck. That means that, in a short procedure under local, the planned incision is made around the belly button but with no dissection around the stalk, and it is then sutured closed. This stimulates or trains increased blood supply to come up through the stalk to the skin of the belly button. This decreases the risk of necrosis of the umbilical skin at the time of tummy tuck. Since a neo-umbilicoplasty can look OK but never looks exactly like a real belly button, it is worth doing the delay procedure and trying to save your belly button if possible.