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Revista Brasileira de Cirurgia Plastica:
doi: 20130100.0-00013
Original Article

Anatomical reconstruction of the umbilicus

Donnabella, Alfredo1

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Background:: The absence of the umbilicus causes significant changes in the appearance of the abdomen, thus making it an essential part of anatomy. The reconstruction procedures should account of the anatomical position to ensure a natural appearance after treatment. The new umbilicus should have a good shape and appropriate position, but should not have an unaesthetic appearance, stenosis, or enlargement.

Methods:: This study included 162 patients who previously underwent open gastroplasty for the treatment of morbid obesity and 2 patients who underwent laparoscopic surgery. We used 2 parallel rectangular flaps measuring 2 × 1.5 cm that were sutured together and fixed to the aponeurosis of the rectus abdominis muscles. The flaps exhibited a curvilinear-shaped skin transition. The attachment flaps were created with 2 parallel points that reached the dermis on both sides of the flap and aponeurosis. Thus, the union of 2 flaps was obtained, which were slightly compressed at their distal portion. Thereafter, the fat tissue around the new umbilicus was approximated.

Results:: The technique described produced all anatomical units including a base, groove, and impeller as well as adequate depth of the umbilical scar in all cases. There were no cases of umbilical stenosis, hypertrophic scars, or keloid scars in the new umbilici.

Conclusions:: This technique for the reconstruction of the umbilicus takes into account the anatomical units and provides a very natural appearance, eventually resulting in a slight excess of skin in the upper portion, thus giving a graceful appearance.

© 2013 Sociedade Brasileira de Cirurgia Plastica

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