Is "Drawstring" Tummy Tuck Incision Procedure Feasible?

Shariaz,
This is a creative idea, but would lead to a terrible result. While some surgeries can be performed through the belly button, these operations just use the belly button as an access site. They make a small incision within or around the belly button to perform the surgery and then close the incision when they are done. They are not resecting any skin during their procedures. Now, it is correct that you can perform an endoscopic plication of your rectus fascia (your six pack) through a belly button incision. However, if you tried to resect any skin and then bunch it all up and sew it to the umbilicus stalk, it would look like a mess. There would be a bunched up appearance with pleats and folds in the skin that would not go away. The advice I have for you is to have a traditional abdominoplasty. While it may seem scary to have an incision, for the most part these incisions heal very well and the benefit is well worth the tradeoff of an incision.
I hope this is helpful.
David Shafer, MD
Shafer Plastic Surgery
New York City

Yes, in rare occasions this has been done but it rarely causes a satisfactory result and more commonly leaves persistently lax skin and a pleated appearance.

Simple rule of biogeometrics (I just made up that word): The more skin that has to be removed, the longer the incision has to be.  Most abdominplasties remove large amounts of skin so long incisions are unavoidable.  If a surgeon tries to cheat, that patient will end up with unsightly irregularties that can be fixed only by extending the incision.  By the way,this "law" applies to all operations.

The key to a good tummy tuck is not just to cut out extra skin, but to also address the underlying abdominal musculature and contour. This cannot be done with only an incision around the belly button in most cases. I would discourage this option in almost all cases.

This would be a great thing, if it would actually work. Unfortunately, using a pursestring-type tension on the abdomen would not pull the skin in the desired directions. 

As you can read from the expert posters here on this forum your issue and possible resultant question are NOT a good idea. I like the thought but the result will NEVER be acceptable.

Best of luck from Miami, Dr. B

most simple solutions to complex problems are seductive and usually Oh, So Wrong!  So, let me lay some "Hope and Change" on you.

The bigger the discrepancy between the final inner circle and the original defect / circle, the more pleating and rippling will be associated with the closure. This is commonly seen with the purse string Round Block Benelli breast Lift repair when used for more than minimal lifts. The result is a permanent sun burst, pleated scar often widened due to the centrifugal outward tension on the closure. An attempt to remove the excess skins from an average thin woman after 2-3 pregnancies with a belly button purse string suture would result in an ugly raised hill of pleats around the belly button. Simple but bad idea.

When performing a tummy tuck, it is essential to work closely with the patient for the position and size of the scar. In our practice, patients bring their favorite bikini to the surgery center to help us determine where the best place another scar is. Here in Miami, patients appreciate a very low scar on their lower abdomen so that they can wear very low-cut jeans and Brazilian bikinis. We perform multiple techniques to make sure that the scar stays in this position and does not widen. A straight and very low well positioned scar is tolerated best.

It is possible to recontour the skin around the belly button with an umbilicoplasty. To create a pleasing scar, however, you are limited by the amount of skin that you can remove. Typically, you cannot remove enough skin comparable to the effects of a tummy tuck.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:
 

Hello,
While it seems like a good idea, the skin would not play well when drawn in like that. It would tend to look very un-natural and "pulled."
Best Regards,
John Di Saia MD
Board-certified Plastic Surgeon
 

I give you a lot of credit because it is a very interesting idea. As others have mentioned, removing the skin is not the only component of a tummy-tuck (abdominoplasty). A good abdominoplasty will reshape the fascia (layer above the abdominal muscles), reshape the abdominal muscles, remove excess skin and fat and restore a youthful, flatter abdomen. This cannot be done from the belly button alone.
Tummy tuck incisions DO heal very well in the vast majority of patients and can be easily hidden. You would be better off with a true abdominoplasty.