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Umbilicoplasty Techniques and Outcomes in Abdominally Based Autologous Breast Reconstruction: A Systematic Review
Thomas J Sorenson1, Lauren Romanowski1, Carter J Boyd1
1Hansjorg Wyss Department of Plastic Surgery, New York University-Langone Health, 222 East 41st Street, New York, NY, 10016, USA.
Background:
Umbilicoplasty is a critical step in donor-site closure following abdominally based autologous breast reconstruction (ABR). While various incision designs and transposition techniques have been described, their impact on patient- and surgeon-assessed aesthetic outcomes remains poorly defined.
Methods:
A systematic review was conducted following PRISMA guidelines. PubMed, Ovid EMBASE, and Cochrane Library were searched through August 1, 2025, for studies evaluating umbilicoplasty after ABR. Eligible studies included randomized controlled trials, cohort studies, and case series reporting surgical technique, aesthetic, and/or patient satisfaction outcomes. Data extraction included study characteristics, surgical techniques, patient- and surgeon-assessed aesthetic outcomes, and complications. Risk of bias was assessed using standardized tools.
Results:
Eight studies comprising 362 patients met inclusion criteria. Umbilicoplasty techniques varied, including oval, U/inverted-U, and Mercedes/inverted Mercedes as well as a neo-umbilicoplasty approaches. Complication rates were low with hypertrophic scarring and umbilical stenosis being most common. Aesthetic outcomes were variably reported, with limited use of validated scales, but generally favored designs that avoid an uninterrupted oval.
Conclusion:
While reported complication rates are low, methodological limitations and underreporting preclude definitive conclusions about technique safety or superiority. Umbilicoplasty should be individualized, with careful attention to perfusion. Future studies should prioritize standardized reporting, validated outcome measures, and multicenter collaboration to strengthen the evidence base and guide best practices in abdominally based breast reconstruction.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
