The Two-Dermal-Flap Umbilical Transposition: A Natural and Aesthetic Umbilicus after Abdominoplasty

Rozen, Shai M.; Redett, Richard J.

doi:10.1097/01.prs.0000261037.69256.3e

Cited by 38 publications

(19 citation statements)

References 8 publications

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“…While both methods reported successful results, we did not wish to perform an incision in the umbilical skin as in the method by Castillo et al [14], and decided on an oval incision. We also noted that the two symmetrical flaps pulled down by Rozen and Redett [13] resulted in a relatively round navel. In their design, the opening for the umbilicus was drawn with a width no wider than 1.5 cm and length no longer than 2.5 cm.…”

Section: Discussionmentioning

confidence: 69%

“…In 2007, Rozen and Redett [13] described an oval shaped incision after which the de-epithelialized dermal flap was incised along the midline, creating two symmetrical flaps. In the same year, Castillo et al [14] used a Y design, de-epithelializing two bilateral triangular flaps and leaving a superior triangular skin flap to coincide with a triangular superior cut made in the navel.…”

Section: Discussionmentioning

confidence: 99%

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A New Method of Umbilical Transposition.

Seo

Kim

Han

et al. 2017

Arch Aesthetic Plast Surg

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INTRODUCTIONAn aesthetically ideal umbilicus sits at the center of a depression on the midline of the lower abdomen at, or slightly above the superior level of the iliac crests, has a longer vertical length than width, and a superior hood (the T-shaped umbilicus) [1,2]. This structure, the remnant base of the umbilical cord, lacks any function save for being the aesthetic landmark that defines the medial abdominal sulcus. The navel, or belly button has become a key cosmetic feature in popular culture, and may affect the person's sexuality. An abnormally shaped or misplaced umbilicus will distort the morphology of the abdomen, attract unwanted attention and cause psychological stress to the patient.Various methods that strive to create an aesthetic umbilicus have been described. Early techniques faced problems associated with scar contracture and hypertrophy, which many have tried to overcome with different, angled incisions. Other important aspects include the appropriate location of the umbilicus, which should be centered on a smooth concavity in the center of the abdomen, the size and proportion of width and length, its shape and degree of protrusion or retrusion, and a slight amount of superior hooding.We introduce an easy-to-learn technique that involves three dermal flaps, with which we have experienced satisfactory results. Background Creating a natural-looking umbilicus during closure of the donor-site in abdominally based free flap breast reconstruction is a factor of satisfaction for both the patient and surgeon. We present a simple method of umbilical transposition that results in an aesthetic, natural-looking umbilicus. od. An oval-shaped incision is made at the location of the new umbilicus on the abdominal flap. This oval is deepithelialized, and full-thickness incisions are made at the 2, 6, and 10 o'clock directions to create three triangular dermal flaps. These are pulled down to the abdominal fascia using sutures that pass through the umbilical stalk and the abdominal fascia at the 3, 9, and 12 o'clock directions. This results in an umbilical stalk lined with dermal flaps, creates a natural periumbilical concavity, and anchors the abdominal flap inward to minimize tension. The cranial flap enhances superior hooding. Results Patient and surgeon satisfaction, surveyed 2 months after surgery with a satisfaction scoring system, were higher in the dermal flap group. Conclusions The technique using three dermal flaps in an oval skin incision is simple, relatively easy to learn, and results in an aesthetic, natural-looking umbilicus. METHODS Ethical statement

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

A New Method of Umbilical Transposition.

Seo

Kim

Han

et al. 2017

Arch Aesthetic Plast Surg

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show abstract

“…Focus on aesthetic results can dramatically shift outcomes and patient satisfaction since an unnaturally scarred umbilicus may be the only visible scar revealing previous abdominoplasty. 1 Many techniques have been described for achieving aesthetic repositioning through horizontal incisions, 2 vertical incisions, 3,4 Scarpa's fascia, 5 deep suture lines, 6-8 single flaps, [9][10][11] multiple flaps, [12][13][14] de-epithelialized flaps, 15,16 dermabrasion, 1 and neoumbilical creation. [17][18][19][20] In designing an approach, malposition, scarring, cicatricial ring formation, and poor form should be avoided.…”

mentioning

confidence: 99%

“…The aesthetically-pleasing umbilicus in thin females tends to be small, shallow, and vertically-oriented in nature, with superior hooding and shadow, inferior retraction and slope, and positioning at the level of the anterior superior iliac crest ( Figure 1). 4,21,22 An umbilicus is usually no wider than 1.5 to 2 cm or longer than 3 cm ( Figure 2), 16,21 and its size is proportionally decreased in smaller and thinner patients. However, with age and weight gain, fat accumulation can cause a deepening and widening of the umbilicus.…”

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confidence: 99%

The Inverted-V Chevron Umbilicoplasty for Breast Reconstruction and Abdominoplasty

Lesavoy

Fan

Guenther

et al. 2012

Aesthetic Surgery Journal

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The umbilicoplasty is a key component of abdominoplasty and closure of autologous abdominal wall donor sites in breast reconstruction (TRAM/DIEP). The aesthetically-pleasing umbilicus tends to be small and vertically-oriented in nature, with superior hooding and shadow, inferior retraction and slope, and positioning at the topmost level of the iliac crest. In this Featured Operative Technique, the authors describe their technique for performing an inverted-V chevron umbilicoplasty, which is their method of choice for restoring the umbilicus to an aesthetic and youthful appearance with minimal scarring.

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“…In modern art, the absence of umbilicus is used consciously to draw attention to artistic anomalies (6) and tiny paintbrush movements can give an impression of a navel that reveals nutrient reserves and individual's vigor (7,8). The importance of umbilicus in social context is supported by the facts that several medicinal companies perform umbilical surgeries to increase the aesthetic value of their customers' abdomens (9), and that umbilicus has been characterized as a sexual symbol in psychology (10). For these reasons, I suppose that a symmetric umbilicus signals high fitness.…”

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confidence: 99%

Umbilicus as a fitness signal in humans

Sinkkonen

2009

FASEB j.

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Typically, mammalian umbilical cord forms a tiny, stable, and asymmetrical scar. In contrast, humans have a clearly visible umbilicus that changes with age and nutrients gathered. Based on this, I propose that umbilicus, together with the surrounding skin area, is an honest signal of individual vigour. More precisely, I suggest that the symmetry, shape, and position of umbilicus can be used to estimate the reproductive potential of fertile females, including risks of certain genetically and maternally inherited fetal anomalies. The idea is supported by a comparative study where symmetrical t-shaped and oval-shaped umbilici of fertile females were considered the most attractive. Further support comes from observations that abnormal velocity of umbilical cord has been associated with fetal brain development, diabetes, and other fitness-related properties with a strong genetically or maternally inherited component. In addition, umbilicus and the umbilical skin area may reveal nutrimental competitive ability, and need for social care in small children and pregnant females. The novel hypothesis explains why umbilicus has aesthetic value, and why umbilicus has had a distinctive role in different cultures. If further research confirms the signalling hypothesis, female umbilici may be routinely measured to detect risk pregnancies of several fetal abnormalities.

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The Two-Dermal-Flap Umbilical Transposition: A Natural and Aesthetic Umbilicus after Abdominoplasty

Abstract: The technique described is simple, safe, and easily learned, and results in a very satisfying aesthetic and natural-appearing umbilicus in patients after abdominoplasty.

Cited by 38 publications

References 8 publications

A New Method of Umbilical Transposition.

A New Method of Umbilical Transposition.

The Inverted-V Chevron Umbilicoplasty for Breast Reconstruction and Abdominoplasty

Umbilicus as a fitness signal in humans

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