A Novel Technique for Umbilical Reconstruction Using Four Transposition Flaps

• Main Authors: Yoon Soo Kim, Eon Ju Park, Hyung Suk Yi, Jin Hyung Park
• Format: Article
• Language: English
• Published: Korean Society for Aesthetic Plastic Surgery 2016-06-01
• Series: Archives of Aesthetic Plastic Surgery
• Subjects: abdominoplasty; surgical flaps; umbilicus
• Online Access: http://e-aaps.org/upload/pdf/aaps-22-96.pdf

The umbilicus is of paramount aesthetic importance for the abdomen, and its absence can be psychologically distressing to patients for cosmetic reasons. An aesthetically-pleasing umbilicus tends to be small and vertically oriented in nature, with superior hooding and shadow, inferior retraction and slope, and a position at the topmost level of the iliac crest. A 42-year-old woman had undergone delayed breast reconstruction using a transverse rectus abdominis myocutaneous (TRAM) flap. Unfortunately, the patient developed umbilical necrosis following surgery. She underwent complete surgical debridement, which resulted in a large vertical scar. Delayed umbilical reconstruction was performed with four transposition flaps. The patient underwent follow-up at 11 months postoperatively, and the umbilicus had a satisfactory appearance. This case shows that using four transposition flaps can yield sufficient depth and an aesthetically pleasing shape for the umbilicus.