Q: Dr. Eppley, I have a large outie belly button that appeared after a prior abdominal surgery about ten years ago. Having had two children afterwards the size of the outie is increasing. Besides the outie, my belly button is way too wide and looks like a ‘sombrero’ to think of the closest analogy that I can. I have attached a picture for your assessment as to how fix this saucer-sized outie belly button. I absolutely hate it!
A: Thank you for your inquiry and sending your picture. Your large outie is likely the result of an umbilical hernia from your original abdominal surgery. (noting the midline abdominal scar above and below the umbilicus) Your belly button repair (umbilicoplasty) would require a combination of correcting the hernia and simultaneously converting the outie into an innie umbilical shape. This can usually be done successfully, particularly when one has the ‘advantage’ of being able to use some of the abdominal scar above and below the belly button. But the key is to repair the hernia which is pushing out on the belly button thus creating its outie appearance. The outie skin can then be tacked back down to the abdominal fascia, recreating an innie funnel look.
Dr. Barry Eppley
Q : Is umbilicoplasty recommended only after you’re done having children? I heard the procedure could be ruined during pregnancy.
A: As a general rule, changing the shape or form of the umbilicus (belly button) is a simple procedure that is usually permanent. However, pregnancy is well known to affect the umbilicus due to its expanding effects. The usual way it can change the umbilicus is to convert an ‘innie’ to an ‘outie’. This is the result of an actual hernia coming through where the umbilicus attaches to the abdominal muscle wall. One must remember that the umbilicus is really nothing more than a scar that goes all the way through to the underside of the muscle wall to the peritoneum. This can be appreciated during a mini-abdominoplasty where the umbilicus is often released and repositioned lower. Once it is cut off at the level of the abdominal wall, a small hernia is immediately apparent.
Because of the potential negative effects of pregnancy on the umbilicus, one should usually wait until after pregnancy for a female umbilicoplasty procedure. If you are converting an outie to an inner, it is possible with the increased abdominal pressure from pregnancy to have it change back to an outie after surgery. The one exception to this id if one is not planning to get pregnant for years. Adequate healing and scarring will then have occurred and it will be able to better resist stretching forces. But if one thinks it is possible to get pregnant within the first year after repair, then one is better to wait.
There are some umbilical changes that may be not be so adversely affected by pregnancy. Removal of skin tags, small scars, nevi, and a ‘pseudoinnie’ (looks like a partial outie but is just a lump of scar tissue) can be done with a low risk of post-pregnancy change.
Dr. Barry Eppley