The umbilicus, or belly button, is the focal point of the abdomen and, as such, it must be located in the proper position and it must maintain an aesthetic shape, contour and configuration.

The aesthetic umbilicus is located at or above the hip bones. It should invaginate, or draw inwards. The youthful umbilicus, ideally, should have the suggestion of a hood above and a valley below. It should be round, oval or ovoid in shape, of the appropriate size and maintain the “nooks and crannies” that typify its architecture.

The umbilicus is traditionally the final detail to be addressed during an abdominoplasty, or tummy tuck. If done properly, with attention to detail, the umbilicus can and should look real, natural and aesthetic enough to display at the beach, pool or in the privacy of one’s bedroom.

Too often, however, it is not given the attention to detail required to re-create an aesthetically pleasing outcome. Oftentimes, it is made to appear as a flat, amorphous opening without shape, contour or definition. Occasionally, it is vertically oriented in linear fashion and narrowed rather than round in configuration. Other times, the size is excessively large blunting the natural appearance of its attractive architecture.

The umbilicus that has been “floated” during an abdominoplasty represents a far greater challenge. In this procedure, the umbilicus is left attached to the overlying abdominal skin and pulled downwards as the laxity is addressed. As a result, a complex array of problems often coexists. The new location of the umbilicus is often low, or malpositioned, and any number of distortions of shape or appearance are present.

Despite all of these challenges, umbilicoplasty can successfully correct many of the deformities delineated above. During the course of an umbilicoplasty, it is sometimes possible to raise its position on the abdomen while simultaneously improving the size, shape, and contour of the resultant umbilicus. Once again, attention to detail is required together with the patience this effort demands. As a result, much can be accomplished in this regard.

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