Umbilicoplasty - Belly Button Reconstruction

Introduction

The belly button, or umbilicus, is a scar acquired at birth when the umbilical cord (which connects the baby to the mother's placenta) is cut. The umbilical cord is essential to the fetus, as this is the only route through which it receives nourishment, and it is through this cord that the waste is removed. The physiologic importance of belly buttons in adults is almost non-existential, which does not mean that the belly button is not prone to any diseases or infections. Caring for and maintaining hygiene is essential in keeping the umbilicus healthy. Belly buttons can be concave (innies) or convex (outies). The shape of the belly button does not have any physiologic impact on a person's health, but a few specific shapes might not be aesthetically appealing to some.

What Are the Conditions Affecting the Umbilicus?

Like any other body part, the umbilicus or belly button is susceptible to infections and injuries. In addition, since the umbilicus is made of folds of skin, there are chances of bacterial invasion if the skin is left damp or if proper hygiene is not maintained.

The most common conditions affecting the belly button or umbilicus are:

• Yeast Infection: If symptoms like swelling, redness, itching, or pain are present in the belly button, it could be a telltale sign of a yeast infection. These fungal infections, similar to vaginal yeast infections or oral thrush, should be treated as soon as possible to alleviate symptoms.

• Cyst: Epidermal cells get trapped inside, forming a painful lump called an epidermoid cyst. This cyst can occur anywhere on the skin, and the belly button is one of them.

• Umbilical Hernia: These hernias happen when a part of the intestine protrudes through the gap behind the belly button, resulting in an outward protrusion of the belly button. Umbilical hernias are more common in babies and usually do not cause discomfort. In severe cases, the child might need surgery to correct it. Umbilical hernias can develop in adults too, but it is pretty rare.

• Navel Stone: Dead skin cells and debris can collect together and form a stone-like mass. It is not a severe condition and can be easily treated by a doctor.

What Is Umbilicoplasty?

Umbilicoplasty can be called belly button reconstruction. This plastic surgery enhances the appearance of the belly button and surrounding skin. Initially, this procedure was done to correct or treat umbilical hernias but later gained popularity as a cosmetic surgical procedure. The main reason why more people choose this procedure is that they better understand the role the belly button plays in improving the aesthetics of the abdominal wall.

The primary reasons for getting an umbilicoplasty done are:

• Umbilicoplasty After Pregnancy

Pregnancy results in loose and sagging skin, especially in the abdomen, due to excessive stretching, which leads to a loss of form in the belly button, which is often aesthetically unappealing. Umbilicoplasty is usually done in such cases, along with a tummy tuck (mummy makeover) to return to the pre-pregnancy body.

• Aesthetics

Convex and concave belly buttons are typical in most cases. The shape and look of the belly button say nothing about its health. But often, people prefer a concave-shaped belly button (or innies) rather than a convex-shaped one (or outsies). An umbilicoplasty procedure can easily attain this. Another reason related to aesthetics that drives people to do this procedure is to repair a piercing scar. Sudden weight loss can also stretch the skin, resulting in an unappealing belly button, which can be corrected by umbilicoplasty.

• Hernia Repair

Umbilical hernia, which is caused by the protrusion of the intestine into the gap behind the belly button or umbilicus, is most common in neonates or babies. In most cases, they self-correct by age five once the gap behind the umbilicus closes. In cases where this does not happen, umbilicoplasty is the treatment choice. Apart from babies, an umbilical hernia can occur in adults as well, but it is not very common.

How Is Umbilicoplasty Done?

The first step in getting any procedure done is finding a reputed, qualified, and verified plastic surgeon who will perform the procedure. There are various factors to be considered while making a choice. For the ease and convenience of patients, the American Board of Cosmetic Surgery has formulated a checklist to help the patient make an informed decision when choosing a doctor.

Umbilicoplasty usually takes an hour to complete. Then, the surgeon will assess the case and give the patient local or general anesthesia, depending on the extent of the procedure. The patient's opinion is also taken into consideration. Typically, the patient can leave the same day, but proper care and rest are necessary to recuperate and heal faster.

Surgeons use various techniques to perform umbilicoplasty, some of which are listed below.

Umbilicoplasty With External Scars

Here, the scars are placed in different directions, which leads to a more effective reconstruction due to the increased flexibility of the skin involved.

Abdominal Flaps

In this technique, flaps are used to reconstruct the umbilicus, which is a more complex procedure usually performed when there is more than one concern to be addressed. The different flap techniques used are:

• Borges technique.

• C-V flap technique.

• Modified “unfolded cylinder” technique.

• Lunch box-type technique.

• V-Y flap technique.

• Twisted flap technique.

• Triangular flap technique.

• Iris technique.

• Umbilicoplasty Without External Scars

This technique does not involve placing scars on the exterior. Various techniques used here are:

• Double-C technique.

• Purse-string suture technique.

• Double circle technique.

• Marconi’s technique.

• Umbilicoplasty With Grafts

This technique involves the placement of a full-thickness skin graft for the base of the belly button. However, there is a considerable risk of failure of graft implantation and infection.

How Is Postoperative Care Done After Umbilicoplasty?

Umbilicoplasty is a fairly simple procedure that a qualified and experienced plastic surgeon can perform. The procedure is usually completed in an hour, and the patient can leave the hospital within a few hours. But postoperative care at home is extremely important for faster healing. The various steps in postoperative care include:

• Take the prescribed antibiotics on time, without fail, to prevent the risk of infection.

• Follow the doctor’s instructions and keep the wound site clean and dry.

• Even though the patient can shower and carry on with their routine activities after 24 hours, it is advised to wait three to four days before resuming any exercise.

• Keep a note of unusual occurrences, like discharge or foul smell, and inform the doctor immediately, which could be a sign of infection. Mild pain and swelling are normal after the procedure.

• If the stitches are not dissolvable, make sure to get them removed after seven to ten days.

What Are the Risks or Complications Involved in Umbilicoplasty?

Like any other surgical procedure, umbilicoplasty also comes with risks. Even though these risks are rare, they cannot be overlooked, and for some people, they might not be worth the risk.

The risks involved are:

• Anesthesia complications or allergies.

• Excessive bleeding.

• Signs of infection.

• Delayed wound healing.

• Scar hypertrophy.

• Nerve or blood vessel injury, which is rare.

• Transient skin erythema.

Conclusion

With the advances in medicine and research, patients have greater access to all treatments. The stigma around plastic surgery is slowly dying, and more people are opting for aesthetic enhancement treatments. Before planning any such procedure, patients should be well informed about the risks and complications involved and be able to choose if the risks are really worth it.