A tummy tuck, or abdominoplasty, is a surgical procedure designed to tighten abdominal muscles and remove excess skin and fat from the midsection. While the focus is on achieving a flatter, contoured abdomen, the fate of the belly button (umbilicus) is a common concern. The umbilicus is a central landmark, and its appearance is paramount to the overall aesthetic success of the procedure. Surgical techniques are specifically designed to ensure the belly button is preserved, repositioned, and integrated naturally into the newly shaped abdomen.
How the Umbilicus is Preserved
During a full abdominoplasty, the belly button is preserved through a process called umbilical transposition; it is not removed and reattached. The surgeon makes an incision around the circumference of the umbilicus to separate the surrounding abdominal skin flap. This allows the abdominal flap (the large sheet of skin and fat) to be lifted and pulled downward toward the pubic area.
The umbilical stalk, which connects the belly button to the underlying abdominal wall muscles, remains completely attached to the body. This attachment maintains the umbilicus’s blood supply and nerve connections. Once the excess skin is removed and the abdominal flap is secured in its new, tighter position, the umbilicus is trapped underneath the repositioned skin.
The final step is bringing the umbilicus back to the surface in its new location. The surgeon creates a new opening, known as the neo-umbilical site, in the tightened abdominal skin flap directly over the original umbilical stalk. The stalk is then brought through this new opening and sutured to the surrounding skin edges.
Designing an Aesthetic Belly Button
Achieving an aesthetically pleasing result is a major focus, moving beyond mere preservation to the design of the new belly button. The goal is to create a natural-looking navel, typically a small, vertically-oriented oval shape with a slight indentation and a hooding of the upper skin edge. The ideal position for the umbilicus is approximately two-thirds of the way up the distance between the pubic bone and the breastbone (xiphoid process).
To hide the scar that results from suturing the umbilical stalk to the new opening, specific incision patterns are used in the skin flap. Common techniques, such as an inverted V, inverted U, or a small star-shaped incision, create a pocket that conceals the circular scar within the natural folds of the belly button. This careful suturing (neoumbilicoplasty) helps ensure the resulting scar is inconspicuous and the navel has the desired depth. Securing the umbilical stalk to the underlying fascia with deep sutures maintains the crucial indentation, preventing the new navel from appearing flat or protruding.
Treatment Differences in Mini Abdominoplasty
The procedure changes significantly when a patient undergoes a mini abdominoplasty, which is a less extensive surgery. This limited procedure focuses primarily on removing excess skin and fat located only below the navel. The incision for a mini-tuck is shorter, typically located low on the abdomen, and does not require the same degree of skin flap elevation.
Because skin movement is limited to the lower abdomen, the umbilicus may be left completely untouched in its original location, eliminating the need for transposition. If a slightly greater degree of skin tightening is needed, the surgeon may temporarily detach the umbilical stalk from the surrounding tissue but not fully separate it from the muscle wall. This allows for downward skin tension without requiring the creation of a new umbilical opening.
In some variations, a technique known as an “umbilical float” is performed, where the umbilicus is detached from the muscle fascia and reinserted slightly lower. This addresses more upper abdominal skin laxity but is distinct from the full transposition required in a classic abdominoplasty. The key difference remains the extent of the skin flap dissection and the necessity of creating a new umbilical opening.
Immediate Post-Surgical Care for the New Umbilicus
The initial healing phase for the newly positioned umbilicus requires specific care to ensure a good aesthetic outcome and prevent complications. Immediately following surgery, patients can expect some swelling and redness, which is a normal response to surgical manipulation. The new umbilicus site will have sutures securing it to the abdominal skin flap, which will either dissolve or be removed within the first couple of weeks.
A primary concern during recovery is keeping the area clean and, most importantly, dry to prevent infection, as the navel is a natural indentation that can trap moisture. Patients are advised to use soft, non-stick dressings to absorb fluid and gently pat the area dry after showering. Submerging the new umbilicus in bathwater or swimming pools must be avoided for several weeks until the incision is completely closed. The final, natural appearance of the belly button will mature over time, with the scar tissue softening and fading significantly after six to twelve months.