DOI: 10.1097/01.prs.0000220010.87241.a7

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PMID: 16772989

Issn Print: 0032-1052

Publication Date: 2006/06/01


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Simultaneous Abdominoplasty and Umbilical Reconstruction Using a Modified C-V Flap Technique

Muhammet Uraloğlu; Fatih Tekin; Hakan Orbay; Ramazan Erkin Ünlü; Ömer Şensöz

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Excerpt

Reconstruction of a neoumbilicus from nonumbilical tissues appears to be a simple procedure, but in practice this is not the case. Umbilicus is an important and essential aesthetic subunit of the abdomen. The shape and configuration of the umbilicus are especially important for females. Thus, any umbilical reconstruction technique should be carefully planned and performed to obtain an aesthetically pleasing umbilical shape with minimal scars. Craig et al. reported that the goal in umbilical reconstruction is to create a small T or vertically oriented umbilicus with a superior hood.1
Previously, Shinohara et al. used the inverted C-V flap for umbilical reconstruction.2 We have used another modification of the C-V flap, which is used for nipple reconstruction.
A 65-year-old female patient was hospitalized for abdominoplasty. On physical examination, it was noted that the patient lacked an umbilicus. A medical history revealed that she had undergone an operation for umbilical hernia when she was a child. Abdominoplasty was carried out with simultaneous reconstruction of the umbilicus.
Preexistent scar tissue on the umbilical site was resected with excess abdominal tissue during the abdominoplasty procedure, and the neoumbilicus was located slightly above the line joining the superior borders of iliac crests. C and V flaps were drawn on the abdominal wall (Fig. 1, above). Unlike in the original technique, we planned for the tips of the V flaps to have a somewhat U shape instead of being sharp. This modification was carried out to increase the depth of the umbilicus. The base of the U flap determines the depth of the umbilicus. After flap elevation, subcutaneous fat was trimmed from the base of the flaps and the abdominal wall to create a depressed area underneath the flaps (Fig. 1, below). Finally, the flaps were sutured to each other and to the underlying tissue to form a new umbilicus (Fig. 2).
A number of techniques for umbilical reconstruction have been described. Matsuo et al. have used the conchal cartilage composite graft.3 Other techniques of umbilical reconstruction utilize the local tissues. Itoh and Arai used a cone-shaped local flap.4 Sugawara et al. used a single triangular local flap.5
We are still searching for the ideal method for umbilical reconstruction. The ideal method should be simple and create a natural-looking umbilicus with minimal scarring. We have described a modified technique for umbilical reconstruction that is adopted from the C-V flap technique used for nipple reconstruction. This technique can be performed in a small amount of time and yields an aesthetically pleasing result.
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