Q: I need to do something with my stomach to make me feel better about myself. I have had two children and the last one really did my stomach in. I didn’t have any stretch marks or loose skin after my first child. But I gained 45 lbs with my second and obviously my skin didn’t like that and now I am left with some loose skin and stretch marks particularly around my belly button. I did have a plastic surgery consult about six months ago and was told that I needed a mini-tummy tuck with a ‘free floating umbilicus’. I didn’t understand what that was and I was worried that my belly button would move around so I never had the surgery. Can you tell me what that is and should I be concerned about it?
A: The fundamental difference between a full or complete tummy tuck and a mini-tummy tuck is in how much skin and fat is cut out and where this occurs. In a mini-tummy tuck this tissue removal is done below the belly button as opposed to a full tummy tuck where it is done above and includes the skin around the belly button. Thus in a mini-tummy tuck, the underlying attachment of the belly button to the abdominal muscles (technically the fascia covering of the muscles) must be released so the upper abdominal skin can stretch down and close to the lower abdominal incision. Before closure the base of the bellybutton is reattached in a new lower position, usually about an inch or so lower than where it was originally. It is only ‘free floating’ for a very short period of time during surgery and is not an issue after surgery. The term free floating is both an historic and poor name which is why it is better known as umbilical transposition or relocation.
Dr. Barry Eppley