Author Topic: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie  (Read 32160 times)

Offline DrBermant

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Hi, I would like to know if it is possible to recieve umbilicoplasty on a belly button that is "Innie", to be turned into an "Outie."

Yes, innie to outie. Not the other way around.

My belly button looks like this


But, I want my belly button to look like this:


Thanks in advance.


The belly button can be the focal point of the abdomen.  Deformity can be embarrassing and of major concern to those with a problem.  Most ask for an "outie" to be converted to an "innie belly button."  Since I have had so many requests, I have come up with a design to make an "outie" belly button.  To date I have no images to show of this new operation. Such new surgery has risks that we are glad to help you explore your options during a consultation or our Preliminary Remote Discussion.

You are welcome to join our group to discuss such issues. However, if you want more specific details, that is something we are glad to help during your consultation. If interested in learning more, Jane is my office manager.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
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Offline Lance

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #1 on: August 09, 2011, 09:18:57 AM »
I have a deep innie belly button but would like to have an outie.  Many people, myself included, can invert their belly button temporarily by pulling it inside-out.  This forms a very attractive outie and I wonder if this would greatly simplify the operation to convert an innie to an outie since there is no real reconstruction necessary.  Would it not just require a surgical method of preventing the belly button from returning to an innie again?

Offline DrBermant

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #2 on: August 09, 2011, 09:28:11 AM »
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I'm writing back due to the procedure (innie to outie) that I would like. I've been gathering money for the surgery, but you said you are now going to retire and are not accepting any more surgery requests? Will you plan to release the details of how this can be done, before retirement? Or will I be unable to ever get this surgery done?


The way this process works is that I find an interesting problem that people as asking for help and let my mind play with the sculpture, analyzing what tools, options, and issues might arise. This is a part of the thinking process of a good Plastic Surgeon. Dr. Thomas Krizek, M.D. used to ask young plastic surgeons during board exams, using the normal tools of Plastic Surgery, buid me a pair of wings on a human body. Now he was not one of my examiners, but I found the question something like what I have been asking myself my entire life. Here is a problem, what can be done?

The next step is to work with such theoretical possibilities with the actual problem in front of me. For some problems I just examine them, document my exam, take my Standard Belly Button Pictures, and continue my thinking process. I then propose that option to that patient explaining the risks, benefits, and alternate methods of care. This offering of surgery sometimes takes place at the consultation, sometimes patients come back to me for further discussions. That patient then decides if they want to accept those risks. Then the surgery takes place. This surgery is part of the creative process where my creativity continues to evolve the concept.  I then document the solution and publish the combined resource.

For the issue of "innie" to "outie" that process has only reached the theoretical step and not seen the further refinement that takes place during clinical exam, then during surgery, and subsequent analysis. The idea of this forum is to let others demonstrate their actual results or theoretical ideas. I envisioned this as a meeting place for those with problems and those with a passion for dealing with it to meet and exchange concerns and proposed solutions.

Someday I may decide to post such an article just as a creative exercise. As of right now, that project is a low priority for me as I have so many more actual problems that I have successful examples of my work. I have so many sculptures of patient problems with proof of solution vs. this theoretical exercise that has yet to see completion of the creative process.

So, you may monitor this forum, contribute to the process of explaining what you would like done, and post your pictures such as my standard views. Other surgeons can post their thoughts, examples, or theoretical approaches. Who knows, perhaps someone will commission me to complete some drawings of what I have evolved so far? In my case will not be a completed surgery as my surgery days are finished. But someone may commission such a piece of art, drawing, or example. Nobody to date has made such a request. Just because I will not be sculpting flesh does not mean I cannot continue to paint, draw, and make such visual art. I have no idea actually what price such art would cost and would have to think about that or if I would want to go in that direction. I am not even certain if such a drawing would work out for a surgery as I often find my ideas just a starting point for my creative process. For example that is how I evolved my Dynamic Technique for Gynecomastia Male Breast Reduction. The sculpture takes form as the problem unfolds during surgery.

Hope this helps,

Michael Bermant, MD
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Offline DrBermant

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #3 on: August 09, 2011, 09:40:10 AM »
I have a deep innie belly button but would like to have an outie.  Many people, myself included, can invert their belly button temporarily by pulling it inside-out.  This forms a very attractive outie and I wonder if this would greatly simplify the operation to convert an innie to an outie since there is no real reconstruction necessary.  Would it not just require a surgical method of preventing the belly button from returning to an innie again?

Welcome to our forum. Why not consider posting Standard Belly Button Pictures to demonstrate your problem, and the contour of this change?

In reality each Belly Button Surgery is it's own unique sculpture. I have seen some belly buttons that have lost their holding forces that anchors them down. That is actually the process of making an innie from an outie. I am adding anchoring forces to attach the skin to deeper structures. For some this lost anchor can result in a terrible deformity with the belly button no longer acting as an anchor force for the stomach leaving an unattractive stomach. But beauty is in the eye of the beholder. In such situations, using my Standard Movies for the Stomach can better demonstrate how the tissues move. That is another option. Take a movie of your process as a demonstration and post a link to that video here. Linking for newbies is disabled to minimize spammers, but I can remove that barrier for such a demonstration, just email me that you have put a link up.

Hope this helps,

Michael Bermant, MD
Learn More About Umbilicoplasty Belly Button Surgery
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Offline Troyie

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #4 on: August 09, 2011, 02:46:38 PM »
Could it be as simple as an incision be made near the belly button, separating the skin, and then something be used to keep it out (a silicon ball, fat transplant, an injection, etc)? I would assume one wouldn't need to separate the bottom of the belly button from anything (some belly buttons can be pulled outwards until the whole belly button can be seen, without any devices, judging from some youtube videos), so it seems to be already detached (thus, a surgeon wouldn't be cutting anything vital).  That all that is needed to keep it "outie", would be something to fill it up, I'm guessing.

I wouldn't know the semantics of it, and I'm not trying to be presumptuous or come off as pretentious (just throwing ideas out there). I really can't fathom many surgeons willing to do it (they don't want to risk anything normally), but there are many people who want to opt for this type of surgery (now that they know it could exist).

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #5 on: August 09, 2011, 06:46:17 PM »
Could it be as simple as an incision be made near the belly button, separating the skin, and then something be used to keep it out (a silicon ball, fat transplant, an injection, etc)? I would assume one wouldn't need to separate the bottom of the belly button from anything (some belly buttons can be pulled outwards until the whole belly button can be seen, without any devices, judging from some youtube videos), so it seems to be already detached (thus, a surgeon wouldn't be cutting anything vital).  That all that is needed to keep it "outie", would be something to fill it up, I'm guessing.

I wouldn't know the semantics of it, and I'm not trying to be presumptuous or come off as pretentious (just throwing ideas out there). I really can't fathom many surgeons willing to do it (they don't want to risk anything normally), but there are many people who want to opt for this type of surgery (now that they know it could exist).

Welcome to our forum and discussion group.

Other than small volume dermal fillers, implants do not do well so close to the surface. In my opinion, the dermal fillers do not do well either as they constantly seem to need new injections as they reabsorb. I have yet to see someone demonstrate such a method and I would be suspicious unless there was long term follow up and how many follow up treatments were needed to maintain that look.

Put a foreign object so close to the surface and the body tends to reject it. It is the same with implants for rebuilding ears, nose, or any right next to a thin layer of skin structure. The implant tends to erode through the thin skin, get infected, and needs to be removed. That is why the reconstruction should be done with the patient's own vascularized tissue. That is the tissue that makes an outie belly button to begin with.

The belly button deepest central skin is supposed to be tightly attached. That is what makes it a tethering point for abdominal movement. As you get away from this central section, the skin is less attached and more mobile. This attached skin is not a simple dissection. It is quite demanding and difficult. Release too much tissue or fail to reestablish a connection and you end up with a free floating belly button or no belly button at all as in this example of Neoumbilocoplasty Making a New Belly Button. A Missing Belly Button Looks Strange as that page attempts to demonstrate.

You can see my attempts to document just how my belly buttons move in the beginning portion of my Tummy Tuck Videos as I focus in on the belly button. I ask my patients to raise their arms up overhead and then bring the arms back down to their sides. This arm movement puts tension on the abdominal skin and you can see how the navel reacts. The second element is watching as the individual bends over and turns in a circle. They are the best methods to date to demonstrate such motion. I can not expect the average patient to show refined motion as did this Belly Dancer Tummy Tuck Video taught me about the healing of this tissue and recovery of muscle function after my surgery (check the first video that page, but for fun watch the entire set of videos and photos that show the power of my Tumescent Tummy Tuck for comfort and recovery.
 
Hope this helps,

Michael Bermant, MD
Learn More About Umbilicoplasty Belly Button Surgery
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Offline Troyie

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #6 on: August 10, 2011, 07:06:14 AM »
What does this mean for the procedure? I'm assuming as you said, a non-silicon implant (with no chance to reject), so tissue displaced from one's own body, transplanted to that area. What would be used that isn't reabsorbed into the body? I'd guess fat transplant, though I could go as far as to say a skin graft..

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #7 on: August 10, 2011, 07:59:40 AM »
What does this mean for the procedure? I'm assuming as you said, a non-silicon implant (with no chance to reject), so tissue displaced from one's own body, transplanted to that area. What would be used that isn't reabsorbed into the body? I'd guess fat transplant, though I could go as far as to say a skin graft..

Fat grafts tend to partially die and become firm. For making a projection in the belly button that would not be as bad, but the problem here is that fat grafts need a robust blood supply to even partially survive. The scarred tissue of a belly button is not a very good blood supply for that graft. That would be a nasty mess: dead fat graft followed by the surface skin loss! No, not an operation I would ever have been willing to offer.

Skin grafts are for resurfacing, not adding bulk. Dermal grafts would be subject to the same blood supply constraints as a fat graft, survival questionable when bulked up and placed into a scar.

For either graft, you would also need to see  a longer term result to see what it looked like until the graft stabilized after initial swelling and subsequent partial to complete loss.

As discussed above, I am not planning now to present my preliminary plans for this sculpture at this time. That is unless you are going to commission that effort at public education? Each method would have its potential drawbacks and potential advantages and some may be better for some variations of this problem than others.

Hope this helps,

Michael Bermant, MD
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Offline Troyie

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #8 on: August 10, 2011, 10:19:24 AM »
It seems that fat transplant is the only somewhat viable option, but very risky as you said. As for silicon transplants, I do know that belly buttons should be much thicker than an ear (which you used as a previous example for transplant/graft rejections), but not nearly as good as a location for something like a breast augmentation would be (since rejection is lowered by quite a bit with how much you have to work with in that area, which makes sense).

If someone had asked for surgery like this before your retirement (as I think you said, you've offered it for years?), what would you have done for them? Would you had to have thought about it for a long while before coming to a conclusion on what's best, or do you think there actually is a way that requires more complicated thinking (maybe something as farfetched as a rod insertion)?

newbielink:http://www.youtube.com/watch?v=2f9MoI8zEk0 [nonactive]
This video is not mine (and not uploaded by me), but shows how flexible some/most belly buttons are. Maybe it can provide some insight to the situation (even for people who can't do this trick)?

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Re: Belly Button Umbilicoplasty Surgery Forum - Make Innie Into Outie
« Reply #9 on: August 11, 2011, 12:11:48 AM »
It seems that fat transplant is the only somewhat viable option, but very risky as you said. As for silicon transplants, I do know that belly buttons should be much thicker than an ear (which you used as a previous example for transplant/graft rejections), but not nearly as good as a location for something like a breast augmentation would be (since rejection is lowered by quite a bit with how much you have to work with in that area, which makes sense).

If someone had asked for surgery like this before your retirement (as I think you said, you've offered it for years?), what would you have done for them? Would you had to have thought about it for a long while before coming to a conclusion on what's best, or do you think there actually is a way that requires more complicated thinking (maybe something as farfetched as a rod insertion)?

http://www.youtube.com/watch?v=2f9MoI8zEk0
This video is not mine (and not uploaded by me), but shows how flexible some/most belly buttons are. Maybe it can provide some insight to the situation (even for people who can't do this trick)?

Sorry, I do not agree about the fat graft being a viable option until someone demonstrates an actual long term example.

The video you post demonstrates non typical anatomy. Most are not able to extract their belly buttons in that fashion. In fact, continued stretching like that can disrupt the remaining tethering forces and the structure may stay permanently out. Some pregnant women have a similar problem during pregnancy and call it a "pop out" belly button that resolves as the anatomy returns to a less stressed state. In some cases it does not and I have had requests to reattach the belly button back to the deeper fascia. For those wanting to keep that structure out, an outie, the issue would be to find that filler that keeps the tissue out and yet maintains the other tethering forces.

This is why careful investigation of before and after pictures is so valuable in validating any technique. I have yet to see someone do so.

Hope this helps,

Michael Bermant, MD
Learn More About Umbilicoplasty Belly Button Surgery
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