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Achieving Aesthetic Results in the Umbilical Float Mini-Abdominoplasty: Patient Selection and Surgical Technique

Wan, Dinah M.D.; Hubbard, Bradley A. M.D.; Byrd, H. Steve M.D.

Plastic and Reconstructive Surgery: March 2019 - Volume 143 - Issue 3 - p 722-732
doi: 10.1097/PRS.0000000000005387
Cosmetic: Original Articles
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Background: The umbilical float mini-abdominoplasty has been criticized for low final umbilicus position and umbilical distortion. The authors believe that in the properly selected patient and with proper technique, the umbilical float can achieve superior aesthetic results in a subset of patients.

Methods: A retrospective review was performed of all umbilical floats performed by two surgeons (B.A.H. and H.S.B.) at the authors’ institution. Postoperative photographs were reviewed by 20 blinded evaluators.

Results: Thirty-one female patients underwent umbilical float mini-abdominoplasty between 2010 and 2017. All patients had starting umbilicus position at or above the level of the iliac crest. The umbilicus was floated for a distance of 1 to 3.5 cm. Average umbilicus position was slightly above the midpoint between the xiphoid and pubis preoperatively, and slightly below the midpoint postoperatively. Final umbilicus was considered “too low” in five patients (18.5 percent), all of which were positioned at the level of the anterior superior iliac spine.

Conclusions: Optimal candidates for the umbilical float mini-abdominoplasty are postpartum women with normal body mass index, mild to moderate infraumbilical skin excess, and minimal to mild supraumbilical excess. Starting umbilicus position should be at or above the level of iliac crests, or slightly above the mid torso. Final umbilicus position should remain above the anterior superior iliac spine. The umbilical base is reattached with multiple sutures to prevent distortion. At least 10 cm of hairless lower abdominal skin should be maintained between the final scar and navel to prevent a low-appearing umbilicus.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Dallas, Texas

From the Dallas Plastic Surgery Institute.

Received for publication May 13, 2018; accepted August 31, 2018.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No funding was received for this article.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (www.PRSJournal.com).

Dinah Wan, M.D., 9101 North Central Expressway, Suite 600, Dallas, Texas 75231, dinah.wan1@gmail.com, Instagram: @dinahwanmd

Copyright © 2019 by the American Society of Plastic Surgeons