Total umbilical reconstruction using a tri-radiate incision technique

Neo-umbilicus aesthetics, often previously ignored or considered an afterthought, is now a major concern in abdominal surgical planning for abdominoplasty in morbid obesity and ventral hernia repairs. Umbilical loss or deformation is immediately recognised owing to its central position causing psychological discomfort, stress and low self-esteem in patients. Several umbilical surgical techniques are described, but there is no universally accepted "standard" technique for umbilical reconstruction. Our purpose was to describe a new method, the tri-radiate incision (TRI) which leads to the creation of an aesthetically pleasing navel, significantly improving the patient's satisfaction and surgeon's cosmetic standards.

This study consisted of 21 consecutive cases of umbilical reconstruction of obese (18) and non-obese (3) patients during abdominoplasty (10) or ventral hernia repair (11) as the main indicators and patient satisfaction was rated post-operatively.

No major post-operative complications such as flap necrosis, umbilical stenosis, flattening or misplacement, cicatricial hypertrophic scarring, infection or haematoma, as recorded in various techniques requiring revision surgeries, were encountered. Serosanguineous discharge observed during the first week was very common. Patient satisfaction with the umbilicus was rated 10/10 by 17 patients and 9/10 by 4 patients from the obese and non-obese categories.

The minimally scarring TRI neo-umbilicus technique offers a new option regardless of age, gender or body mass index in creating a neo-umbilicus that is safe, reliable and reproducible using a single-staged procedure. It achieves all the permanently desired aesthetic standards, with relatively little or no post-operative complications but high patient satisfaction in abdominoplasty and hernia repair.