Umbilicoplasty Revision for Slim Patient?

The depth of your belly button depends on a couple of factors:

How short your umbilical stalk was in the first place, and if it was shortened intra-operatively.
How thick your abdominal flap was at the time the belly button was inset into it.

You describe yourself as thin, and certainly if you had a full tummy tuck, your abdominal tissues are stretched even thinner. If your belly button was not shortened intra-op (it probably was not, since you are not obese), then my advice would be to wait until your abdominal tissues relax a bit. Some tissue laxity around the belly button might improve its shape and depth.
I'm sure some of the more experienced surgeons on this forum have some tricks for this problem, so stay tuned for their answers.

Without seeing photos of your before and after, it is difficult to tell you if it would be worthwhile for you to under go an umbilicoplasty revision. There are several things that can create a not-so-perfect belly button after abdominoplasty, and some can easily be corrected, and some are more difficult. If you have lost confidence in your surgeon, I would recommend getting a second and possibly even third opinion. You may end up having more confidence in your original surgeon if you hear the same thing from others, ore you may find someone who can give you the results you want to achieve. But I would advise you to discuss this with your original surgeon so that he/she has the opportunity to go over it again with you. Good luck!

I have observed this in extremely thin patients. It is difficult to create a hooded or deep umbilicus there is no thickness to the walls of the umbilicus.

Your surgeon is right that making a nice belly button on a slim patient is very difficult, because there is no way to create the natural depth. The best thing in my experience is to try to create more of a hood across the top, which can be done under local anesthesia. it's worth giving it a shot because a nice umbiilicoplasty is one of the hallmarks of a good abdominoplasty and I am sure your plastic surgeon want to make it better.

The umbilical appearance is somewhat crucial after abdominoplasty as it is harder to hide than the lower transverse scar with usual summer clothing/bathing suits. The hardest thing to fix afterwards would be an umbilicus that is not on the midline. In fact that may not be completely fixable.
What makes the belly button look natural after surgery is as you stated depth and upper hooding when standing upright but also a more or less vertical ellipse outline with a scar that lies in the depths of the belly button (over the rim). You cannot get that if the surgeon brings the belly button out through a round incision with a scar that runs from the 11 to 1 o'clock positions along the rim. Also if the opening is made to large it can stretch out and flatten the belly button.
If you had posted a picture this reply could have been more detailed/specific.

I have been there. For very thin patients getting any "depth" to the belly button can be difficult. You may not be able to do much, even with a different surgeon.

Hello,

In order to figure what might be possible I need to see what the problem looks like. An examination is better. There might be something to do but without looking at you it is hard to predict.

 

Best Regards,

 

John Di Saia MD

I think your doctor shouldn't jump to conclusions. When I redo the belly button during a tummy tuck I suture or stitch the top of the belly button to the fascia or the thick layer of tissue over the muscle. This pulls the belly button down to create the depression that women have. However, unless it's 6 months out your surgeon is jumping to conclusions (unless he knows what happened during surgery).
So give it time and if it's not good after 6 months see someone who can create a good belly button.

The outcome of Cosmetic Plastic Surgery is commonly not only dependent on how we, the plastic surgeons, perform an operation ("play the cards") but also on your presenting anatomy ("the cards you deal us").
Post-operatively, a round belly button (not a vertical slit), " innie" with depth and hooding is the goal of a well done umbilicoplasty (which is part of the Tummy Tuck (Abdominoplasty) procedure. But it is not always completely achievable.
The deep / innie look is dependent on the balance between your skin's subcutaneous fat, the length of your umbilical stalk and the extent of muscle repair / plication done during your tummy tuck (the more - the better as it shortens the stalk and pulls the umbilicus closer to the muscles).
A conservative muscle repair in a thin patient with a moderate to long umbilical stalk which are unrecognized or not fully addressed will generate an average to poor result. Such patients require their umbilical "cup" to be stitched to the adjacent muscle fascia lining to BOTH "shorten" the stalk and force the skin to come down to the umbilicus creating an attractive, deep belly button.
If the appearance of your belly button is important to you, do not settle for this result. I would advise you seek out qualified Plastic surgeons and see what they offer. Your present result could be vastly improved.
Good Luck.
Dr. P. Aldea

If your doctor does not feel comfortable to do the revision, I would suggest that you follow his advise. He has opearted on you and he knows the anatomy of your abdomin and also the reason that it did not turn as you both expected.
Please submit a picture.