Particularly in large cases in which the stalk of the belly button is large and in cases of delayed healing, the belly button scar may not end up as close to the center as we would like.
A small operation under local can tweek it but just a little bit.
It would be a bigger deal to re-open the whole incision and try to “float it”.
I have only had a few “tweek” patients over the last twelve years and they seem to be OK with the improvement.
In smokers, a “float” is not a good alternative anyway due to reduced blood flow issues. (John P. Di Saia, MD, Orange Plastic Surgeon)
An off-center belly button scar after tummy tuck can be recentered with local anesthesia.
If the belly button is off center by only a quarter of an inch, it can be reposition with local anesthesia. There are several ways to do it but tightening the fascia on the opposite side of the deviation can move it laterally without any further scarring on the abdominal wall.
A second option is to make a lateral skin incision and pull it towards the midline by way of skin tension. The navel may, however, have a slanted funnel. (Vincent N. Zubowicz, MD)
Repositioning the belly button scar after a tummy tuck
A tummy tuck is a very popular and effective way to contour the abdomen. During this procedure, your physician has elevated the flap of skin and fat in your lower abdomen and pulled it in fairly. In fact, your belly button remains in place. It is only the skin around it that moves downward.
A great deal of care must be taken to ensure that the belly button is re-created in the middle of the abdomen. If the belly button is off center, there are possible remedies. If you have enough laxity in the lower abdomen, you may be a candidate for a revision in tummy tuck where basically the tummy tuck is performed again and a brand-new belly button is created.
If the belly button is mildly off center, you may benefit from an umbilicoplasty where the skin around the belly button is reorganized and base of the belly button can be shifted laterally. At this stage, your best bet is to work with a board-certified plastic surgeon with a great deal of experience in abdominoplasty and belly button revision techniques. (Pat Pazmino, MD, Miami Plastic Surgeon)
Umbilicus revision
If your umbilicus is off- center, it can be centralized but it may leave a bit of a scar lateral to where it was before the revision. (Steven Wallach, MD, Manhattan Plastic Surgeon)
Belly button scar after Abdominoplasty
The position of the belly button scar during abdominoplasty is determined by the umbilical stalk. In most cases, the position of the umbilicus on the abdominal wall is not changed during a tummy tuck procedure.
Interestingly, a study performed a few years ago determined that in most patients, the position of the umbilicus is actually off center. Discuss this study with your plastic surgeon as it was published recently in PRS journal. In answering your question, there are several ways to mobilize the umbilicus if it is off center. These should be discussed in the context of your physical examination. (Raffy Karamanoukian, MD, FACS, Los Angeles Plastic Surgeon)
Surgery can advance the belly button but is that all that is wrong here. A quarter inch is minimal and may be an omen of other complaints. (Robert M. Freund, MD, New York Plastic Surgeon)
Belly button can be re-centered after tummy tuck
Your plastic surgeon does have the ability to re-center your belly button. One quarter of an inch is a very short distance and can usually be done rather easily without incurring further scarring. (Kenneth R. Francis, MD, Manhattan Plastic Surgeon)
Re-centering belly button can be difficult
The correct location for your belly button after a tummy tuck is in the mid line, and level with the top of your hip bone or pelvis. You can locate the point by placing your thumbs firmly on the top of the pelvis at your waist and follow your index finger around your waist to the mid line.
With tummy tuck, the belly button scar is kept where it started, at its attachment on the abdominal wall and “brought through” after all skin excess is removed and all is closed. We spend a good amount of time on this last step, as the belly button scar is my most unfavorite part of the procedure, and I want to get it right.
The position can be influenced by changes in tension on the skin as the abdomen heals, or on such things as leg length discrepancy. The very small amount of shift, the 1/4 inch your mention may be something which can be revised by widening to the inset in the opposite direction.
Look at the whole picture, though. If the umbilicus is pretty with a nice shape and minimally visible scar just where it is, there may be trade offs. If you can’t get your mind off of it, however, it is worth a second look by your surgeon. (Peter E. Johnson, MD, Chicago Plastic Surgeon)