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Christopher K. Patronella, MD, FACS, FICS homepage


Creating a Natural-Looking Belly Button During Tummy Tuck Surgery

Posted May 23, 2024 in True Form Body Contouring®, True Form Tummy Tuck®, Tummy Tuck

Restoration of the belly button is a surprisingly complex aspect of tummy tuck surgery. It’s one of the top concerns women tell me they have about the procedure. Many have seen the results of friends who wound up with artificial-looking navels after undergoing a tummy tuck (abdominoplasty). Since one of the most common goals patients express is the desire to wear a 2-piece swimsuit with confidence, an inconspicuous and natural-looking belly button is an important element of the True Form Tummy Tuck® procedure. To that end, I developed a 6-step technique to restore an ideal aesthetic appearance to the belly button.

Tummy Tuck Belly Button Pitfalls
In the video, I’m going to show you a few of the patients I’ve seen over the years who had tummy tucks done elsewhere and were dissatisfied with the appearance of their belly buttons. They consulted with me to give them my recommendations regarding how to repair the following concerns:

Triangle Belly Button
This is just a poor design for a belly button. I don’t know where this came from, but it has no resemblance to a natural belly button.

Bulging Belly Button
This belly button is bulging due to a hernia that was not adequately repaired.

Hypertophic Scarring of the Belly button
Occasionally a patient will have this kind of contracted scar around the belly button. It usually is the result of too much tension along the skin edges. While this typically can be prevented with the proper technique, some patients do have a tendency to form thick scars

Suture Striations
If external stitches are placed to bring the skin together, they can leave these vertical marks. This can prevented by using a different kind of surgical closure technique. Internal stitching is what I prefer so this doesn’t happen.

Vertical Slit
When not enough fat is removed around the belly button, that fat compresses the skin, and a slit forms. This can be prevented as well.

Expanded Round Belly Button
The is probably the most common type I see. The scar around the belly button is placed too far outward, and it looks expanded like a donut. It’s very unaesthetic, and there are some ways to prevent this from happening.

Dr. Patronella’s 6-Step Technique for a Natural-Looking Belly Button

In the research I conducted, ideal aesthetics for a belly button had the following characteristics:

  • Deep inward-contour
  • Subtle vertical-orientation
  • Firm skin tone

During pregnancy, the belly button expands along with the abdomen as the baby inside grows. After childbirth, the navel and abdominal skin commonly appear stretched out. To restore the belly button’s youthful, authentic-looking contour, I developed a 6-step process I incorporate during a True Form Tummy Tuck procedure.

Step 1
I create skin flaps that I can advance down to the base of the belly button by making an incision in the skin’s surface.

Step 2

The fat around the belly button is thinned. This fat is sculpted out so we don’t have that crowding of fat around the belly button which could compress it and prevent it from having the depth and width I am creating at this step.

Step 3
I stitch the dermis to the base belly button in such a way to create contour because that’s what looks most natural.

Step 4
I stitch the dermis to the base belly button in such a way to create contour because that’s what looks most natural.

Step 5
If the belly button is too long, it can be shortened to a more proportional projection.

Step 6
The belly button is stitched to the external skin of the abdomen in a very specific way so that the belly button is internalized and the scar is along the inside of the abdominal skin rather than the outside where it could expand out.

In the featured patient’s “after” photo, you can see the result of this method: the dermis is attached to the base of the belly button, and the navel itself is deep and has an attractive, authentic-looking shape. These steps are a bit technical, but I think it’s useful to share them to demonstrate that some thought and planning goes into creating a belly button that is inconspicuous, and which blends beautifully with the elegant, toned appearance of the abdomen following a True Form Tummy Tuck procedure.

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