Neoumbilicus in abdominoplasty: points of finesse

Abstract

Most of the scar and resulting ‘dog ears’, as a result of abdominoplasty, are inconspicuous and can be well hidden in the clothing. Neoumbilicus is often at display and an aesthetically pleasing umbilicus heightens the patient satisfaction from such a procedure. This paper discusses our technique of restoration of the umbilicus. The neoumbilical site is marked 1 cm inferior to the projected stalk. A small ellipse is excised and a core of adipose tissue is excised in a conical fashion underneath it. The umbilicus is anchored to the rectus sheath at 3, 9 and 6 o’clock points in the described manner. We then discuss the importance of the vector of pull on the umbilical stalk and relate this to production of an aesthetically pleasing superior hood. The technique creates an aesthetically pleasing umbilicus that is sited in a gentle depression, with a superior hood. The technique has been used on 40 patients in the last 4 years who have been followed up for at least 6 month. The various points of finesse and the details of the senior author’s technique are presented by means of illustrations and photographs.