A patient flew into El Paso last month to ask me about two things that had bothered her since a prior surgery: a belly button that healed flat, and a raised scar on her lower back. Seven minutes of consult dictation answered both. I am publishing the exchange nearly as it happened, identifiers removed, because patients keep asking me the same questions.
Her: Why does my belly button look flat?
Me: “When I went in, there was very little skin. I have to make it like a new one from scratch. This is the only skin you had, the tiny bit in the middle. It’s the only skin you had that was actually the belly button. So I have to bring in this to make it look in, and so we don’t see a scar. And I think it’s gonna look a lot better.
“And then depending on how it heals, or even during the surgery, sometimes I put a little bit of fat around it so it gives it more of a depth. So we can start planning. It should only be probably about a thirty, forty-five minute procedure.”
Her: They wanted you to look at the back. One of the scars is raised.
Me: “So there’s two choices here. It’s like a hypertrophic scar. So one is to put steroid in it. It’ll make it flatter, but it’ll probably make it wider. The other one is just to do a revision, do this area here and then re-suture it, and it should heal better because there won’t be as much tension as the first time. That will probably give you a better-looking scar in the end. Is this the part that you’re most concerned with, the part right here?”
Her: Yeah, just the raised part.
Me: “I think if we do the steroid, it will be flat, but it will get wider. So I think it’s gonna look better if we actually do the revision, and since we’re gonna be doing something anyway, we could just do the back at the same time.”
Her: Not putting me out, right? We can still do it with local?
Me: “It’ll probably take a little longer, probably about an hour.”
Both procedures, one visit, local anesthesia only. My exam note from that day: “Patient doesn’t have much belly button skin, so it looks flat. We will have to do a new umbilicus with possibly some fat grafting, and revision of the hypertrophic scar in the back and the coccyx area.”
The takeaway
A flat or scarred navel after a tummy tuck or other abdominal surgery is fixable. On its own it is a thirty to forty-five minute procedure. Paired with a scar revision, about an hour. For the right patient, no general anesthesia at all.
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and I teach plastic surgery as a Clinical Associate Professor at Texas Tech University Health Sciences Center.
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If your belly button or a scar has been bothering you, let’s look at it together. Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at drworldwide.com.
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