Belly button issue, 3 weeks post-op from mommy makeover (Photo)

Wow, 5 answers thus far, and other than Dr. Wald, everybody has "answered" by saying you should see your surgeon because they can't see beyond the crusts and scabs. At least Dr. Morgan told you your belly button "doesn't look as it should."
The good news is that it is not malodorous or painful, and the surrounding healthy tissues do not appear to have a cellulitis either.
However, I see no evidence from your single photograph that the umbilicus is alive. Perhaps there might be small remnants of living tissue, but this needs to be considered a nonviable belly button, and treated as such. This means local wound debridement, topical agents that penetrate dead tissue and minimize the risk of warm, wet, dead tissues becoming a nidus for bacteria that could destroy any residual living belly button remnants or cause infection in the surrounding healthy abdominal skin, and oral antibiotics for the same reasons--minimize bacterial invasion of healthy surrounding tissue and more tissue loss.
Further good news is that once the dead stuff is gone, healing can resume, and the scarring that contracts and replaces what used to be your belly button actually becomes a pretty convincing and normal-appearing "new" belly button.
But you can't just let this go and hope all will be well.
Forewarned is forearmed--telling you to just go see your surgeon to "clean up crusts and scabs" is not letting you know that your surgeon will need to make you aware of your dead belly button, and giving you a framework for what needs to be done by your surgeon.
Let's face it, this is a known complication of tummy tuck. Most plastic surgeons who have done lots of tummy tucks will see this complication, and usually it is not because they did something "wrong." Often umbilical hernias can compromise circulation to the belly button after an incision is made around it. Sometimes a thick abdominal flap can stretch the blood supply to the umbilicus. Sometimes it just has minimal circulation and doesn't heal.
And, some patients will always seek to "blame" something or their surgeon when things don't go perfectly. Even when there is no surgical error, and even when patient compliance is perfect, and even when there is no smoking involved, belly buttons can die. Please re-read the fourth paragraph above--the one that starts with "Further good news . . ."
Now I believe it is appropriate to tell you to go see your surgeon so this can be put on the path to best healing going forward. You have a very good chance that your result will not be harmed by this occurrence--it will just take a bit more work and time. More good news: and probably no additional surgery, either. Best wishes! Dr. Tholen

Hello. Great question. I am sorry for your post op difficulties. At 3 weeks you are still early in your recovery process. It is not uncommon for wound dehiscence to occur post op. You have yet to see your final results. Keep following your surgeon's post op instructions.

It is not uncommon to develop some bleeding around the edges of the belly button following surgery. This will appear as a dry black crust or scab. Occasionally, some necrosis of the edges of the umbilicus can also occur causing this appearance. Please see your surgeon and he will be able to explain in more detail.

Dear Alifedesigned,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. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It will take several weeks for your swelling to subside and the swelling will impact the appearance of your belly button. I encourage you to discuss your concerns with your surgeon. He/She will update you on appropriate wound care for optimal healing.

Hey there,As you correctly said, it should heal in 3 weeks but from your picture and description, it looks like there is partial skin necrosis of umbilical skin without any infection. You just need to wait until the scabs fall off and till then visit your surgeon regularly to make sure there is no infection and you get proper wound care.
Hope this helps.

It could be a couple of different things.  It may just be some dried blood/scabbing that will fall off eventually vs. a small amount of necrosis from a lack of blood supply to the stalk of the umbilicus.  It is difficult to say without examining you in person.  Either way, it will heal with time.  I would advise seeing your plastic surgeon to assess what is going on and how to treat it for the best outcome.  Good luck! 

Good Morning, Thank you for your question and photo.  It is a bit difficult to see, however without knowing the specific technique and examining the area in person, it is hard to predict how you will heal.  It is best to check in with your surgeon so your progress can be tracked.Best of Luck,Dr. K.