First, some facts. Some peoples bellybutton sits slightly higher on their abdomen than others. Second, some people seeking a tummy tuck do not have that much loose skin to remove. Third, ideally when evaluating somebody for a tummy tuck, the thumbs are placed just above the top of the pubic hair, and the fingers placed just barely above the TOP of the belly button and pinching the fingers together should be relatively easy. If it is, this means that everything between the fingers can be removed, and this means that the skin from the upper abdomen will stretch downward to the lower portion of the abdomen. During a tummy tuck, an incision is made around the belly button, and the bellybutton stock is left in place. This means that there is now a hole in the abdominal skin. If the skin at the top of that hole can easily be brought down and sutured to the skin just above the top of the pubic area, this skin hole can be removed because it lies within the excess skin that will be removed and, once the incisions are sutured closed, you would only have a lower abdominal incision, and your belly button would be brought out through a new opening created in the upper abdominal skin which has been pulled downward. However, if the opening created in the abdominal skin by cutting around the belly button CAN NOT be removed when the abdominal skin is pulled downward, it must be closed as a small (3-4 cm) scar which is positioned some distance above the lower horizontal scar. Choosing this option allows the horizontal scar to be placed as low as possible. For patients who do not wish to have the small vertical scar above the horizontal scar, and they are not fully intent on having their horizontal scar as low on their tummy as possible, it is possible to shift the position of the lower horizontal scar upward so that the skin just above the belly button could be approximated to skin lower on the abdomen without too much tension. One final option is an “umbilical float“. In this procedure, no incision is made around the bellybutton, but when the abdominal skin is elevated and pulled inferiorly, the stock of the belly button is cut underneath the skin, where you can’t see it, and the belly button is moved lower as the upper abdominal skin is pulled downward and sutured back at a slightly lower position. I hope this increases your understanding. Best wishes.