
==== Front
Plast Reconstr Surg Glob Open
Plast Reconstr Surg Glob Open
GOX
Plastic and Reconstructive Surgery Global Open
2169-7574
Lippincott Williams & Wilkins Hagerstown, MD

GOX-D-24-00471
00024
10.1097/GOX.0000000000006141
3
Cosmetic
Ideas and Innovations
Umbilical Lift: A Simple Effective Procedure to Rejuvenate the Umbilicus
Nassab Reza MSc, MBA, FRCS(Plast), Consultant Plastic Surgeon
From the CLNQ, Manchester, United Kingdom.
Reza Nassab, MSc, MBA, FRCS(Plast), CLNQ, 11 Owen Street, Manchester M15 4YB, United Kingdom, E-mail: contact@rezanassab.com, Twitter: @rsnassab, Instagram: @nassabplasticsurgery
9 2024
06 9 2024
12 9 e614130 4 2024
17 7 2024
Copyright © 2024 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Summary:

The umbilical lift procedure is a useful technique for improving the skin laxity in the upper umbilicus, which is commonly seen in patients with umbilical piercings who have had children or with aging.

OPEN-ACCESSTRUE
COUNTRYUNITED KINGDOM
==== Body
pmcTakeaways

Question: How can you improve the skin laxity above the umbilicus?

Findings: The umbilical lift can help improve the appearance and reduce the laxity of skin.

Meaning: The umbilical lift is a technique to reduce the skin laxity above the umbilicus, restoring a more youthful appearance.

There have been a number of studies highlighting the aesthetically pleasing umbilicus. Craig et al found that an oval or T shape with slight superior hooding or shelf was the most aesthetically pleasing shape in their survey.1 Another survey by Cavale et al also confirmed that the hooded oval with hood (T shape) was the most aesthetically pleasing shape.2

The aging process and changes in skin quality or laxity following piercings, pregnancy, or surgery have consequences on the appearance of the umbilicus. A Japanese study identified changes in umbilical shape with aging. Sakamoto et al found that vertical length and depth increased significantly with age. They reported a change from a Chanel-shaped umbilicus, which is one with superior and inferior hooding, in childhood to a more almond shape in adulthood.3 A French study also showed that aging resulted in widening and deepening of the umbilicus.4

Patients with previous umbilical piercings often present with thinned lax skin overlying the piercing tract. This skin is often thinned further following pregnancy, resulting in an area of skin laxity directly above the umbilicus. This is often more significant in patients with a lower body mass index and lower percentage body fat.

The umbilical lift is a simple and effective procedure to reduce the skin laxity in this area and improve the shape of the umbilicus. The aim is to change the area of skin laxity in the upper umbilicus from a horizontal into a more oval and youthful shape.

Preoperative marking is performed using the preexisting piercing or skin laxity as the extent of the skin excision. The lower incision is based on the upper aspect of the umbilicus and follows the edge of the umbilical rim. The upper umbilical skin laxity is pinched to assess the amount of redundant skin for removal. When the pinch test is performed, the upper incision is marked at the maximal pinch. These markings then provide the extent of skin excision. A crescent skin excision pattern is drawn, which allows recruitment of the upper skin which is fed into the lower shorter incision. The procedure is performed under local anesthesia with direct infiltration of the area. Full-thickness skin excision is performed, incorporating any preexisting piercing tracts. The skin edges are approximated using a deep dermal suture with 3/0 Monocryl. A subcuticular layer using 4/0 Monocryl is then used. Any areas where there are raised edges due to length discrepancy are sutured using interrupted 5/0 Vicryl rapide. [See Video (online), which displays the umbilical lift procedure illustrating the key steps in performing this simple and effective procedure.]

This technique has been used in five cases to date, performed by the author. A case of a 30-year-old woman is shown preoperatively and 1 month following the procedure (Figs. 1 and 2). The follow-up has been from 3 to 10 months. There is often some mild puckering of the scar initially, but this has settled in all cases. There have been no complications such as wound healing problems, infection, or hypertrophic scarring. No patients have required scar revision following the procedure.

Fig. 1. A 30-year-old woman with skin laxity of the upper umbilicus following a piercing. There is a more horizontal shape to the umbilicus.

Fig. 2. The postoperative result at 1 month following the umbilical lift resulting in more round and youthful appearing umbilicus shape.

Video 1 shows the umbilical lift procedure, illustrating the key steps in performing this simple and effective procedure.

1_piuj27tt Kaltura

This procedure can help alleviate the localized skin laxity in the upper umbilicus often following a piercing. The shape of the umbilicus is changed to a more youthful appearance featuring some of the aesthetically pleasing characteristics. The procedure is simple and can be performed under local anesthesia. It is indicated in patients with very localized skin laxity in the upper umbilicus. Patients with more widespread laxity and significant redundant skin may be more suited to an abdominoplasty procedure.

DISCLOSURE

The author has no financial interest to declare in relation to the content of this article.

Published online 6 September 2024.

Disclosure statements are at the end of this article, following the correspondence information.

Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com.
==== Refs
REFERENCES

1. Craig SB Faller MS Puckett CL . In search of the ideal female umbilicus. Plast Reconstr Surg. 2000;105 :389–392.10627008
2. Cavale N Butler PEM . The ideal female umbilicus? Plast Reconstr Surg. 2008;121 :356e–357e.18176269
3. Sakamoto Y Kamagata S Hirobe S . Umbilical shape by age and growth: a Japanese study. Plast Reconstr Surg. 2010;126 :97e–98e.20220560
4. Correia N Jayyosi L Chiriac S . Morphometric analysis of the umbilicus according to age. Aesthet Surg J. 2018;38 :627–634.29126239
