Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was performed in a 2 years old boy. The case of a 2 years old child with proboscoid umbilical hernia. The protruding umbilical skin was excised sharply by two V-shaped cuts leaving two half cones, a short cephalic (0.5cm) and a long caudal (1cm). A classic herniotomy was carried out, with repair of the facial defect. The caudal half cone was sutured from its apex till half it's length upon itself with interrupted sutures and it was anchored deeply to the fascia. Then we inverted the cephalic half cone which was sutured to the caudal cone to form the new umbilicus. The early result was excellent with no complications and the result after 2years revealed a cosmetically satisfactory shape of the umbilicus. this technique provides a good solution for reconstruction of the protruding umbilical skin and it is easy to learn, easy to be taught and perform in surgical environments and may be applicable for any kind of umbilical reconstruction.

the mandible. Outcomes included length of hospital stay, intraoperative complications, wound complications at the donor site, shoulder weakness on harvest side, flap necrosis or dehiscence, and need for repeat surgery. RESULTS:Median age of the patients was 77 years (range 68-78), and ratio of male to female was 5:3. Median length of stay was 11 days (range 10-15). 2 of the 8 patients had previous failed FFF. No intraoperative complications occurred. One of the patients had a wound infection at the donor site and none of the patients experienced shoulder weakness or experienced flap necrosis. 3 patients experienced partial intra-oral flap dehiscence that were managed conservatively and 2 patients experienced intra-oral dehiscence that required re-operation. CONCLUSION:The PLDF is a viable option for primary coverage of lateral head and neck defects due to its large bulk. Additionally, it serves as an important salvage option for patients with failed FFF. In comparison to the pectoralis muscle flap, it does not distort the breast anatomy/give an anterior scar, flap is more reliable, and frozen neck after radiation would be avoided. With the increasing incidence expected in head and neck lesions, this forgotten flap may prove to be more important for providing optimal wound coverage of these challenging lesions.