Abdominoplasty, commonly known as a tummy tuck, is a surgical procedure designed to address excess skin and underlying muscle laxity in the abdomen. This surgery is frequently sought by individuals following significant weight fluctuations or pregnancy, which often leave the abdominal profile stretched and weakened. As people consider this body contouring operation, one of the most frequent questions concerns the fate of the belly button, or umbilicus. Patients often ask whether they receive a completely new navel or if their existing one is preserved and incorporated into the newly tightened skin, a process that relies on careful surgical technique to reposition this central feature during the procedure.
Understanding the Tummy Tuck Procedure
A full abdominoplasty begins with a long, horizontal incision placed low on the abdomen, extending from hip to hip, and positioned to be concealed by underwear or a bikini bottom. The surgeon carefully lifts a large skin and fat flap toward the ribcage, separating it from the underlying muscle wall. This elevation allows access to the abdominal muscles, which are often separated and stretched, a condition known as diastasis recti. These muscles are then tightened with internal sutures, creating a firmer internal corset and a flatter abdominal plane. Because the entire skin flap is pulled downward significantly to remove excess tissue, and the underlying navel structure remains fixed to the abdominal wall, the surgeon must address the umbilicus to prevent it from being dragged unnaturally low on the abdomen.
The Umbilicus: Preserved, Not Replaced
The body does not receive a “new” belly button in the sense of a different anatomical structure being created from scratch. The existing umbilical stalk, which connects the navel’s visible skin to the deeper abdominal wall, remains attached to the muscle layer. During the initial skin flap elevation, the surgeon makes a circular incision around the navel to detach the surrounding skin from the stalk, leaving the original structure anchored in its natural position on the abdominal fascia. This technique preserves the patient’s own tissue, as the navel acts as a fixed point while the surrounding skin is mobilized and pulled downward. The skin flap is then draped over the abdomen, concealing the original stalk until the surgeon marks the proper location for the navel on the stretched skin, typically aligning it with the center of the torso.
Surgical Techniques for Repositioning the Navel
After the skin flap is pulled taut and excess tissue is removed, the surgeon performs umbilical transposition by creating a new opening for the preserved stalk to emerge. A small incision is made in the marked location on the overlying skin flap and shaped to create a natural-looking aperture. Surgeons often employ specific incision patterns, such as a vertical slit, an oval, or an inverted-V shape, rather than a simple circle, to encourage a recessed and vertically oriented final appearance. The preserved umbilical stalk is then brought through this newly incised hole in the skin flap. The edges of the navel are meticulously sutured to the edges of the new opening under minimal tension to ensure a seamless transition and that the navel appears naturally sunken.
Aesthetic Outcomes and Scar Management
The final appearance of the belly button is a key factor in patient satisfaction following an abdominoplasty. Skilled surgeons aim for an aesthetic result that mimics the natural, vertically oval shape and is appropriately recessed, meaning it dips inward. Recession is achieved by anchoring the navel’s deep tissues to the muscle fascia. An unavoidable periumbilical scar circles the border where the navel is sutured into the new skin opening, but surgeons work to minimize its visibility by hiding it within the natural creases and folds of the re-created navel. While initial swelling may be present, the appearance improves over the first year as the tissues settle and proper post-operative scar care is followed for the most refined final aesthetic outcome.