Belly Button too high and flat post TT. Hernia not repaired correctly? (Photo)

Hello BlueMaeve in Ponderay, ID. Thank you for your question regarding the issues you're experiencing with your belly button and hernia repair following your full tummy tuck in October 2023.

From your description and the photos provided, it seems there are a few concerns to address: the positioning and appearance of your belly button and the effectiveness of the hernia repair.

Belly Button Concerns:
It's understandable to be dissatisfied if the belly button appears too high and feels flat. Adjusting the position of the belly button is indeed possible. If you feel that your belly button is positioned too high, a surgical revision can be performed. This would typically involve creating a new opening for the belly button at a lower position on your abdomen, which can also help deepen its appearance. This process does involve making an incision around the current belly button and possibly creating a new scar, so it’s important to consider whether the potential aesthetic improvement aligns with your expectations.

Hernia Repair Issues:
Regarding the hernia repair, it's standard to suture the fascia rather than the muscles. If there is bulging, this could indicate that the hernia repair might not have held, or there could be other issues like post-surgical swelling or even the formation of a new hernia. An ultrasound or MRI would be useful in diagnosing the exact issue, confirming whether the hernia has recurred.

Surgical Revisions and Costs:

Revision Surgery: This could involve both repositioning the belly button and reassessing the hernia repair. Each of these procedures would require careful planning to ensure that the final result meets your expectations.

Cost: The cost of surgical revisions can vary widely based on the complexity of the surgery, the surgeon’s fees, anesthesia, facility fees, geographic location, and whether any of the procedures are covered by insurance, especially if the hernia repair is deemed medically necessary.

Recovery: Recovery from such revisions would likely be similar to your initial tummy tuck recovery, typically requiring a few weeks of reduced activity and several months for all swelling to subside and final results to stabilize.

Given your concerns and the dismissive response you've encountered, seeking a second opinion from another board-certified plastic surgeon with extensive experience in complex abdominal surgeries might be advisable. They can provide a fresh perspective on what can be realistically achieved with revision surgery.

I hope this information helps clarify the options available to you and assists in planning your next steps. Good luck as you continue to seek improvements and satisfaction with your results.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Dear BlueMaeve,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello; if your belly button is pointing upwards; stalk remained at below; incision for the new belly button; that means; it was made above. If your skin is loose; but your flesh is not loose; if you have fat in your abdomen; by doing Vaserlipo; the skin is loosened and tension sutures are applied. The abdominal skin; can be fixed in a lower case. Thus, the belly button; can be lowered to where it needs to be. For non-fat people, deepening for the belly button; it becomes too hard.

Unless you have some excess upper abdominal tissue, the belly button cannot be lowered until you do have some excess. If the hernia is not repaired, it still can be done. A CT scan might be helpful to check it and insurance should cover the hernia repair.

Tummy tuck surgery should be considered permanent and you reversible.
I don’t think every revision of your belly button is going to make it look better, but instead will make it look worse.
Your outcome looks fairly typical.
Best,
Mats Hagstrom, MD