Abstract
Background
The umbilicus is a central aesthetic landmark of the abdomen and a key determinant of patient satisfaction after abdominoplasty. Although preservation and transposition of the native umbilicus are feasible in most cases, certain anatomical and surgical conditions render umbilical preservation unsafe or impractical, making neo-umbilicoplasty a reconstructive necessity.Objectives
To describe a novel neo-umbilicoplasty technique based on anchoring the neo-umbilical flaps to the residual umbilical pedicle and to evaluate its aesthetic outcomes, reliability, and complication profile.Methods
A retrospective single-surgeon study was performed on consecutive patients undergoing full abdominoplasty or lipoabdominoplasty between March 2022 and March 2024 in whom the native umbilicus was excised and reconstructed using the described technique. Indications included large umbilical hernias, compromised or elongated umbilical stalks, severe rectus diastasis, and revision cases. Aesthetic outcomes were assessed using a standardized Likert scale (1-5) by two blinded plastic surgeons at 3, 6, and 12 months. Patient satisfaction was evaluated using a visual analog scale (VAS, 0-10). Umbilicus-related complications and long-term morphological stability were recorded.Results
Thirty-six patients were included, with a mean follow-up of 11.2 months. The mean composite aesthetic score improved from 4.12 at 3 months to 4.48 at 6 months and remained stable at 12 months. Patient satisfaction increased from a mean VAS of 8.6 to 9.2, with sustained results at late follow-up. No cases of umbilical necrosis, stenosis, progressive flattening, or loss of depth were observed. All complications were minor and managed conservatively.Conclusions
Neo-umbilicoplasty through umbilical pedicle anchoring provides accurate positioning, durable depth, and high aesthetic satisfaction with minimal additional fascial stress. It represents a reliable reconstructive option in complex abdominoplasty cases when native umbilical preservation is not feasible.Level of evidence ii
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