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Natural Umbilicoplasty Without Visible Scarring: An Easily Taught and Reproducible Technique
Joshua T. Henderson, MD
Luis H. Quiroga, MD, MPH
Jack Gelman, MD
West Virginia University Division of Plastic Surgery
2023-02-10
Presenter: Joshua T. Henderson
Affidavit:
I certify this material has not been published or previously presented. This work represents the original work of the resident. I agree to my electronic signature.
Director Name: Kerri M. Woodberry, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Goals/Purpose:
Recently, an excellent technique was described that results in a scarless caudal umbilicus with superior hooding (2022 Samargandi). A similar technique has been used by this abstract's senior author (J.G.) for over 20 years and has subsequently been implemented in our residency training. This tension-minimizing inset can simplify the abdominoplasty closure.
Methods/Technique:
As an inverted-V inset, the apex of the inferiorly based flap is sutured to the umbilical stalk and to the rectus fascia. Umbilical inset prior to abdominoplasty closure decreases the vertical tension on the low transverse wound, enabling a safe resection of the inferior excess tissue while decreasing the risk of a widened umbilicus.
Results/Complications:
This technique has been taught to all residents in our training program and quickly incorporated in our abdominoplasty closures. Gradual relaxation of the abdominoplasty flap results in a natural-appearing umbilicus with adequate depth and a camouflaged inferior inset. Our patients frequently comment on the "untouched" appearance of their umbilici. All residents have been able to independently perform this technique and have reported increased confidence with umbilical positioning.
Conclusion:
The technique is easy to teach and can be easily adopted by surgeons in practice, as well as in training. With this technique having recently been described, it is practical to incorporate its inclusion in residency education. The inset during abdominoplasty flap advancement, prior to final resection of the inferior excess skin, can simplify decision-making for where to position the umbilicus and how much inferior excess tissue to resect.
