Clinical Papers: Northeastern Society of Plastic SurgeonsLow Scar Abdominoplasty with Inferior Positioning of the UmbilicusColwell, Amy S. MD; Kpodzo, Dzifa MD; Gallico, G. Gregory III MDAuthor Information From the Division of Plastic Surgery, Mass General Hospital, Boston, MA. Received February 22, 2010, and accepted for publication, after revision, February 28, 2010. Presented at the 26th Annual Meeting of the Northeastern Society of Plastic Surgeons, Charleston, SC, September 2009. Reprints: Amy S. Colwell, MD, Division of Plastic Surgery, Massachusetts General Hospital, 15 Parkman St, WACC 435, Boston, MA 02114. E-mail: [email protected]. Annals of Plastic Surgery: May 2010 - Volume 64 - Issue 5 - p 639-644 doi: 10.1097/SAP.0b013e3181db759c Buy Metrics Abstract Miniabdominoplasty with umbilical free float has received little attention in the literature in 15 years and has been criticized for an abnormally low umbilicus. We hypothesized the umbilicus in women presenting for abdominal contouring is positioned higher than ideal and thus may benefit from lowering. In addition, we felt modifications of the original umbilical float technique would improve aesthetic results. A retrospective review identified 60 patients aged 34 to 56 who had abdominoplasty with umbilical fascial transection and inferior positioning. Technical modifications included low placement of a full transverse abdominal scar, abdominal flap undermining to the rib cage, more inferior umbilical repositioning, flank liposuction, and plication of diastasis recti from xiphoid to pubis. Patients did not have enough excess skin to allow traditional abdominoplasty without a high-transverse or vertical midline scar. No umbilical or incisional skin necrosis occurred. To assess optimal umbilical position, plastic surgeons were asked to draw the ideal position on pre- and postoperative photographs from 5 patients. The mean ideal umbilical position was 2.2 cm lower than the actual position (P < 0.01) in preoperative photographs and was close to the true position in postoperative photographs. In conclusion, lower abdominoplasty with inferior umbilical positioning is an excellent choice for the middle age, postpartum woman with excess abdominal skin and full length diastasis recti but a normal body mass index. © 2010 Lippincott Williams & Wilkins, Inc.