Umbilicoplasty Revision? Tuck? Anything? Why Can't I Get Even Close to a Consensus? (photo)

Loose skin from pregnancy. Many consults 10 years ago. Opinions ran the gamut. 1 was very conservative and recommended umbilicoplasty which I had never heard of. I hated the results and swore never again. But now I'm back to doctors hoping for a solution. For every 1 doctor that says that a tuck could be performed, 3 say I shouldn't. Regardless of the quality of the pics it has been confirmed that there is no diastasis recti, little fat. Stretch marks galore. Why am I not a candidate? Or am I?

Doctor Answers 8

Looks to me like a tummy tuck would be the answer

As others have pointed out, you have a very long distance form your belly button down to where one would want the abdominoplasty incision.  This makes it difficult to promise a fantastic result.  At the same time, it appears you have enough skin, both above and below the belly button, to be able to reposition the belly button up into some normal looking tissue, and at the same time, get a good closure of your abdominoplasty incision.  The closure would be very tight, it will take you at least 2 weeks to stand up straight, and unfortunately, the scar will probably be visible at least in the midline outside of the underwear you are presently wearing.  All that being said, I think the surgery will give you a cosmetic improvement and a nice looking belly button (umbilicus). 
The reason you will be able to do this surgery a second time is because there are 2 blood supplies to the umbilicus - one from the liver (which how your mother fed you when you were inside her), and one from the skin.  This is certainly a most complex operation and needs a Board Certified Plastic Surgeon with lots of abdominoplasty revision experience. 

Abdominoplasty will remove excess skin and improved abdominal contour

In my opinion you are a candidate for an abdominoplasty/tummy tuck. It will remove the excess skin, improve the abdominal contour and get rid of the poor scar around the belly button.  Hope this helps solve the dilemma.  Please have a consult with a board certified plastic surgeon who specializes in body contouring surgery.  Good luck.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Tummy tuck or not?

It's easy to advise you.  What might not be so easy is for you to come to terms with the decision you will need to make around the trade off of the abdominoplasty scar.

Here are the facts:

1. Your abdominal wall generally will look better if you have an abdominoplasty (tummy tuck).

2. Your belly button will look much better after an abdominoplasty.

3. I suspect you do have a diastasis - not a bulge, but you don't really have a defined waist.  A repair will narrow your waist as well as the tuck will improve your skin tautness and the umbilical appearance.

4. You do not need a vertical scar. You need a long horizontal scar as low as it can be positioned.


5. You have a high umbilical position naturally.

6. Therefore there is concern that the horizontal scar would end up being too high - that is, visible above the underwear you are wearing in the photo.

7. Most likely but not absolutely the scar could be positioned low enough.  It depends on the elasticity of the skin above the umbilicus which has to stretch out.

8. If the scar ended up too high it could be further lowered at a secondary transverse low wedge skin excision 6 months after the abdominoplasty when the skin has relaxed.


So I think peoples advice to you may be confusing largely because your umbilical position is naturally high... and therefore the tradeoff of changing your current situation for a new one with a better torso, but a long low transverse scar is not necessarily an easy one to make.

Now you know this - and you may already have known it - the decision is yours to make and no one else's.

Good luck.

Tummy tuck time

You would get the best result with a tummy tuck. There are many ways of doing the procedure but you have a significant distance between your pubic area and the belly button so if the incision is kept low(preferred) you would have a vertical scar in the lower part of the belly. However, the skin would be tight, the belly button improved and the lower abdominal scar can be hidden in panties or a bathing suit. 

Not sure who did the original surgery or why that procedure was done?

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

To Tuck or Not To Tuck

Thank you for the photos and questions.  You have a difficult problem because your peri-umbilical tuck did not work well. There is no way now to get skin out from your pubic area to above your belly button so that your scar will remain low and hidden in your bikini.  If you get a tummy tuck, there will be a vertical scar in your lower abdomen from the closure of the hole cut to release your belly button.  If you are going to seek out another surgeon, please be sure they are board-certified by the American Board of Plastic Surgery.  Hope it goes well.

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

Tummy tuck or not

My best advice would be to see a real plastic surgeon with lots of experience in abdominoplasty.  After examining you, he or she can give you a considered opinion as to whether an abdominoplasty will get you to your goal.  From the photos you sent, it seems to me that a tummy tuck should work.

Michael Leff, MD (retired)
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

Umbilicoplasty revision

Dear Ms. Drake,


Based on your pictures, you are a candidate for a Lateral Tension Abdominoplasty. In this procudure all the skin is removed from your belly button down. This will also remove your umbilicoplasty scar. A new umbilicoplasty will them be performed at the same time which will look natural with minimal if any scar visibility. This is typically because of the contractile forces on you belly button are no longer circumferential but vertical which will give you a better result. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

Tummy tuck ?

It is really hard to tell you from those photos. You have a long rise from the pubis to your belly button so it may not be possible to get out all of the skin without a small vertical incision. That being said, an in person consultation would be needed to tell you what would be best for you.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.