The best belly button.
I know it may seem silly, but to me perhaps the most important part of a tummy tuck is that little crease, no more than a centimeter, that is the belly button. Why so important? Well a tummy tuck by definition is a scar operation. We pull down loose abdominal skin creating a scar in the lower abdomen. While every effort is made to minimize this scar, it is real and permanent, but fortunately well hidden. Good scar or not, the bikini or underwear will usually hide it. The belly button is another story—it is an unhidden scar and in most cases the only visible sign of a tummy tuck. In my opinion, it can make or break the result.
I pretend that all of my tummy tuck patients will want to wear a two piece bathing suit on the beach one day. Because of this I feel compelled to create the best belly button I can.
Plastic surgeons have described heart shapes, “U” shapes and a variety of special belly button patterns that I do not use. I find them cumbersome and unnatural looking. My philosophy is about size. I prefer a small belly button and here’s why:
Nothing is as natural as a G-d given belly button. Therefore, keeping the surgical belly button unobtrusive is my first goal. Smaller draws less attention; larger looks like a tummy tuck belly button.
I pretend that despite my best efforts the patient will make a thick scar and I would rather have a small thick scar than a big one.
Erring on the size of small is safer. If a belly button is too small it is very easy to make it larger, but it is very difficult to make a large belly button smaller.
There are other subtleties as well. The opening can be vertical or horizontal. Vertical looks better but horizontal can allow me to lower the lower abdominal incision, removing more tummy skin.
The inside of the belly button can be pulled up or down as need be. It is important to leave a reasonable distance between the belly button and the bathing suit line. I will sometimes shorten the inside or even reshape it if it has been stretched or flattened by pregnancy. I like to tether it inwards a bit, which can help keep more of the scar on the inside.
Paying attention to these details not only makes the best belly button, but the best tummy tucks as well.