Should I be worried that the center of my abs don't line up with my belly button? (photo)

In an attempt to keep the abdominoplasty incision short, your plastic surgeon pleated your skin towards the midline.This combined with your very thin skin has led to a midline indentation in the middle of your abdomen.  Belly buttons are not a midline structure.  They tend to be off to one side or the other on most individuals.  This slight asymmetry would be much less obvious if you and your plastic surgeon decided to revise the abdominoplasty incision and extend it laterally.  This would also get rid of many of the wrinkles in the mid portion of your abdomen.  Many plastic surgeons believe that patients want a short abdominoplasty incision.  I personally believe that if the incision is low, thin and fine, it will be acceptable to most patients and won't have the untoward appearance that your abdomen presently shows. 

The indintations are likely the result of pleating of the skin in an attempt to minimize your overall scar length. You may need to have the procedure revised to a full length abdominoplasty incision in order to correct the indintations.