Umbilicoplasty Revision After Full Tummy Tuck, Thin Patient

Question

I am 5'7, 130 lbs, athletic, with a lot of abdominal muscle tone.I had a full TT done in November 2010.My belly button didn't have any depth after my TT so in February 2011 we decided to do an umbilicoplasty to try and correct the problem.The revision, again, didn't turn out as we hoped. My belly button is flat with zero depth.I'm scheduled for another revision in just a few months but I am a little discouraged.Is it going to be difficult for my doctor to correct this mistake?Any advice?

Miguel Delgado, MD · Answer

This is a difficult problem because your fat content around the area is small. trying to rebuild an inny belly button is difficult for this reason. The only option is to minimize the scar as much as possible, make it smaller with a purstring suture.

William Bruno, MD · Answer

I would wait a few months longer and allow your skin to fully heal from the last revision before you have another attempt at revision. The scar tissue needs time to soften before you have surgery again.

	Best wishes,

	Dr.Bruno

Kamran Khoobehi, MD · Answer

Scar revision will not help an will make the suitation worse. The better option would be fat grafting to tissue around the belly button so it would seem deeper

Darryl J. Blinski, MD · Answer

Very difficult issue to repair the depth appearance of the umbilicus. If after the second attempt you are still unhappy try skin color tattoos to appear as shadowing giving the impression of depth.

Steven Turkeltaub, MD · Answer

Despite what would seem to be a fairly straightforward problem, an umbilicoplasty in a thin person like yourself is challenging aethetically. There are limitations with regard to outcome but it is reasonable to wait a few months before attempting a revision of your results.

Margaret Skiles, MD (retired) · Answer

You present a very challenging problem as you not only have a flat bellybutton but also hypertrophic scarring from your previous procedures. It would probably be prudent to wait as long as you can before considering any further surgery to allow time for the scarring to soften. Scarring is usually at its most hypertrophic and stiffest at 4-6 months after surgery. Since any revisionary surgery would involve manipulating the skin, the softer it is, the better. For you, the stiffness should be starting to decrease about now, so the longer you can wait, the better. Good luck to you.

Robert M. Grenley, MD (retired) · Answer

It appears that you have hypertrophic scarring where your belly button should be. I have seen patients whose belly button has been obscured by surrounding thick hypertrophic scarring essentially hiding the BB beneath, and I have seen patients whose belly buttons were lost due to inadequate blood supply (necrosis) and subsequently healed with just scarring and no recognizable belly button to speak of. You do not mention that your belly button was "lost" and was an open wound and took weeks to heal in, so I am unsure what actually transpired. In any event, the difficulty is cutting out your scarring and making the resulting hole smaller in diameter prior to anchoring it down to the fascia. There are many techniques, described, but most of them do result in some surrounding scars...in other words, scars that extend out from the BB in order to close down the larger diameter defect into a smaller diameter BB with perhaps a scar that runs inferiorly for an inch or two, versus multiple scars that extend out from the BB perhaps a half inch each. In terms of making an "inny", if you are very thin, your BB can never be much of an "inny" because there is no thickness of surrounding fat for it to "dive" in through. But, when the time is right, at least something can be done to make your BB look more like a BB.

Richard P. Rand, MD, FACS (retired) · Answer

Please don't refer to this situation as a "mistake" because you are obviously very thin and as such can never have a deep belly button. The only way you can have that is if there is enough of a wall of fat around the umbilicus so it looks deep.

Umbilicoplasty Revision After Full Tummy Tuck, Thin Patient

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