Umbilical Float or Full Tummy Tuck for High Belly Button?

OMG.  After reading all the responders' comments to your question of tummy tuck vs. umbilical float, I am totally confused, and I have done hundreds and hundreds of tummy tucks and a handful of umbilical floats myself.  I disagree with the surgeons who say umbilical float is not a good operation and that you don't get a normal belly button.  I have done it several times in very unique situations with positive and attractive results.  That having been said, I personally think you could have a full on tummy tuck. 

There, I have done it.  I have added to the confusion.  Here is my suggestion.  Of all the Board Certified surgeons you have seen, who do you feel the most comfortable with, who has the best before and after pictures, who has given you the name of several of his patients and you have talked with them about their experience with his or her tummy tucks.  To me, that is the answer.  You don't want to pick the technique, you want to pick the surgeon. 

You are going to trust this plastic surgeon with your life and your looks.  Don't limit them as to what they can do for you.  I love the internet.  It has educated not only patients, but also surgeons.  The problem is, there is so much information out there that patients are now making surgeons decisions. 

You pick the surgeon, let the surgeon make the surgeon's decisions.

There may be enough skin to make a  full tummy tuck the best option. There is a lot of laxity in the mid abdomen (a lateral view would have been very helpful).  When this large bulge is completely flattened, all the skin that is going up the curve to the belly button will be lax and may be sufficient to get the belly button hole down close to the incision or to remove it entirely. An in-person exam helps to clarify this, because if one can take the skin above the umbilicus and compress it vertically by about 9 cm, there should be enough skin to do the full tummy tuck.  If there is a small low vertical scar at the incision line, sometimes after six months the skin relaxes and more can be removed to get rid of the scar.

The abdominal wall contour can undergo significant changes
when women have twins.Under these
circumstances, it’s not unusual for women to develop loose excess skin,
weakened muscles, fat accumulation and stretch marks.It’s important to realize that no two
patients are ever exactly the same and for this reason it’s important to
individualize care. Although
it’s hard to make a specific recommendation without a physical examination,
your history and pictures suggest several problems.It appears that you have a high umbilicus and
a low C- section scar in the presence of weakened muscles and a small umbilical
hernia.These anatomic findings
significantly limit treatment options.In your case three options exist, an umbilical float abdominoplasty,
traditional full abdominoplasty with a high incision or a vertical incision
with a traditional abdominoplasty.The
choice of procedure not only depends upon your anatomic findings, but your
aesthetic goals as well.The umbilical
float procedure can be utilized, but in many cases results in distortion of the
umbilicus with a shallow unnatural appearance.This procedure also limits the ability to perform secondary procedures
if they should become necessary.For
these reasons, the majority of plastic surgeons would recommend a variant of
the full abdominoplasty.In most cases,
surgeons would fix the umbilical hernia and tighten the muscles and reassess
the skin laxity.In rare cases, enough
excess skin might be present to perform a traditional abdominoplasty through
the C-section scar, while in other cases a vertical incision might be used. It’s
important to realize that the specific procedure chosen will depend upon the
patient’s anatomic findings, aesthetic concerns and intra-operative
factors.For these reasons, it’s
critical that patients thoroughly discuss their options with their surgeon, so
they have a complete understanding of their options.

Floating abdominoplasty uses a small incision in the lower abdomen to allow for the tummy to be tightened and shaped. No incision around the belly button is needed. Through the incision, excess skin is removed and muscles can be tightened. The belly button is temporarily detached during the surgery to allow for this. You experience muscle tightening from sternum to pubic area. After the belly button is reattached (and moved down if necessary) the incisions are sutured. Liposuction can be performed if necessary to eliminate excess fat. Please see an experienced board certified plastic surgeon for a physical examination to determine which treatment would be most suitable. A floating abdominoplasty may help you. Good luck.

I would recommend for my patients a tummy tuck with diastasis repair and umbilical hernia repair if they appeared as you do in this picture.  An umbilical float is a reasonable alternative, but it would not be my first choice. Good luck.

In agreement with full tummy tuck for the shape you will achieve, my preference over umbilical float is to pull all the way down and in from the sides for the lowest possible scar.  If I cannot get it low enough to cover with your preferred panties without excessive tension, will add a short vertical suprapubic midline component that has never been a problem.  It is so well hidden, and can always be revised in the office if it is visible.  You only show a front view, but appear to have enough peri-umbilical connective tissue compliance that plication of full tummy tuck is absolutely necessary.  Your supra-umbilical skin can sometimes advance a surprising amount, especially once the underlying abdominal wall is tightened.  Another helpful measure is progressive tension sutures intra-operatively to facilitate flap advancement and low scar.

You would do great with an umbilical float.  The muscles can be repaired, the belly button brought down and the scar kept low. 

Best wishes,

DoctorMeade

You will get a lot of opinions here, and without an exam, its hard to give you the best advice. In general, I feel that the float procedure is usually not a great idea. On the other hand, the vertical scar you would have with a full tummy tuck usually heals extremely well. Therefore, I would favor a full tummy tuck (with a short scar not much longer than your c-section scar), a full muscle repair, and a short vertical component. Good luck.

Hi Babyab - From you photo, it looks like you're a great candidate for a mini-tummy tuck with floating of the umbilicus. The scar is small, low, and allows great access to tighten the abdominal muscles. It doesn't appear that you have enough skin for a full tummy tuck. The recovery for a mini tummy tuck is about 2 weeks off of work and 6 weeks from lifing more than 5 lbs to protect your healing abdominal muscles. Good luck!

I reviewed the other surgeon's answers and I don't blame you for being confused. There is no right or wrong answer, merely opinions and preferences based on experience. I would probably favor and umbilical float because this weould allow me to correct lower AS WELL AS upper abdominal skin laxity, fix the hernia and the diastasis while preserving the vascularity of the umbilicus.
If you are considering a full tummy tuck, you may require laparoscopic repair of the umbilical hernia to maintain viability of the stalk.