Umbilicoplasty for large protruding umbilicus accompanying umbilical hernia: a simple and effective technique

Abstract

A large umbilical protrusion with redundant skin accompanying an umbilical hernia sometimes needs umbilicoplasty. Although several different techniques for making umbilical depression have been used, the results of the plastic surgery are sometimes unsatisfactory due to postoperative flattening or disappearance of the umbilical depression. To make a permanent umbilical depression that is cosmetically acceptable, we have modified the techniques. Umbilicoplasty was performed in 14 children whose ages ranged from 6 months-6 years and 3 months (median, 1 year and 10 months) and who had umbilical hernia with a large umbilical protrusion. After the fascial defect was closed, the diameter of the umbilicus was reduced to half that before surgery by removing fan-shaped skin flaps and approximating skin edges, and then inverting the umbilicus and fixing it caudally to the fascia and skin. There were no postoperative complications, and no flattening or disappearance of umbilical depression was observed during the follow-up of 10-19 months. The authors' technique of umbilicoplasty for a large protruding umbilicus accompanying umbilical hernia is a simple method that produces acceptable cosmetic results.

Umbilicoplasty in children with huge umbilical hernia

“…With the double half-cone umbilicoplasty, [11] after 3 cm of fascial defect, the cosmetic result will be discussed because the neo-umbilical rim will be too large. The technique of Ikeda et al [12] is adapted for UH that BD is between 2 and 2.5 cm; it cannot provide good result with what we call HUH. With HUH, even in Group 1, there will be an added scar, even with the "lazy M" and omega flaps.…”

Pediatric Abdominal Wall Defects

“…Some support umbilicoplasty to achieve an aesthetic repair. 51 Further study into the genetic mechanisms associated with the normal programmed umbilical closure may reveal additional novel approaches to the repair of these hernias.…”

Umbilicoplasty with 3 triangular skin flaps and excised diamond-shaped skin flap

“…Some authors have reported modified techniques that can be used in patients with large umbilical hernia [1][2][3]. However, these techniques sometimes cause unsatisfactory results, particularly postoperative infraumbilical flattening and disappearance of the umbilical depression.…”

“…Procedures are usually performed through a curved infraumbilical incision along the umbilical ring [1][2][3]. However, in cases of large umbilical hernia, these surgical techniques cannot diminish the diameter of the umbilicus, and unsatisfactory results are sometimes encountered, such as remnant of a large umbilical ring, postoperative flattening, or disappearance of the umbilical depression.…”