Abstract

This case report details the successful outcome of a delayed umbilicoplasty performed on a 36-year-old healthy woman who previously underwent umbilical hernia repair. Despite successful hernia repair, the patient was dissatisfied with the appearance of her protruding umbilicus. Umbilicoplasty, using a V-Y advancement flap technique, was performed under local anesthesia to address excess skin and fatty tissue around the umbilicus. The procedure resulted in a cosmetically pleasing outcome without complications, significantly improving the patient's satisfaction and quality of life. This case highlights the efficacy and safety of umbilicoplasty as a corrective procedure for aesthetic concerns following umbilical hernia repair, emphasizing the importance of addressing both functional and cosmetic outcomes in surgical interventions.

Key Words:

Umbilicoplasty, Umbilical hernia, V-Y advancement flap, Case report.

Introduction

Umbilical hernias are common, and their surgical management is well-established. However, the aesthetic aspect post-repair is often overlooked. This case report highlights a unique scenario where umbilicoplasty was performed to address cosmetic concerns following umbilical hernia repair, using a V-Y advancement flap technique to address excess skin and fatty tissue around the umbilicus (1). This approach showcases the potential for improving patient satisfaction and quality of life through aesthetic correction post-hernia repair (2).

Case Report

Patient Information:

The patient, a 36-year-old otherwise healthy woman, underwent umbilical hernia repair in December 2021. Despite successful hernia repair, she expressed dissatisfaction with the appearance of her protruding umbilicus. There were no significant medical or family histories pertinent to this case.

Clinical Findings:

Physical examination revealed a protruding umbilicus with visible bulging, consistent with the patient's concerns.

Timeline:

• December 2021: Umbilical hernia repair performed.
• January 2024: Umbilicoplasty performed for cosmetic correction.

Diagnostic Assessment:

Physical examination was the primary diagnostic method. The diagnosis of umbilical hernia was confirmed during the initial evaluation.

Therapeutic Intervention:

Umbilicoplasty was performed under local anesthesia to correct the aesthetic appearance of the umbilicus. The V-Y advancement flap technique was used in this procedure to address the excess skin and fatty tissue. The steps involved included:

1.Patient Evaluation and Marking: Thorough assessment and marking of the desired new position and shape of the umbilicus.

2. Anesthesia: Administration of local anesthesia to the umbilical region.

3. Incision and Flap Creation: Creation of a periumbilical incision and a V-shaped incision within the circular incision, with the apex of the V pointing away from the umbilicus.

4. Tissue Dissection and Excision: Dissection of the flap from the underlying tissue and excision of the excess skin and fatty tissue as shown in Figure 1.

5. Advancement and Closure: Advancement of the V-Y advancement flap towards the new umbilical position, ensuring tension-free closure as shown in Figure 1. (3).

6. Dressing and Postoperative Care: Application of a sterile dressing and provision of postoperative care instructions (4).

Figure 1: Intraoperative procedure picture of the umbilicoplasty.

Follow-up and Outcomes

The patient reported satisfaction with the cosmetic outcome of the surgery as shown in Figure 2. There were no adverse events or complications during the follow-up period.

Figure 2 : Results of the umbilicoplasty at 5 months post-surgery.

Discussion

This case underscores the importance of addressing cosmetic concerns in patients following umbilical hernia repair. While hernia repair focuses on functional outcomes, umbilicoplasty can significantly enhance aesthetic results and patient satisfaction (2). The successful outcome of this case suggests that umbilicoplasty can be safely performed under local anesthesia with favorable results. In cases where there is significant redundancy or bulging of the umbilical region, techniques such as the V-Y advancement flap can be employed to achieve optimal aesthetic outcomes (1, 2).

Informed Consent:

Informed consent was obtained from the patient for the surgical procedure and publication of this case report.

Financial Disclosure Statement:

The author declares that there are no conflicts of interest regarding the publication of this case report.

References

1. Smith LP, Lee WPA. Umbilicoplasty for aesthetic and reconstructive purposes. Ann Plast Surg. 2017;78(6S Suppl 5):S287-S292.

2. Kim JL, Kwon JY. Umbilicoplasty: Indications, techniques, and outcomes. Arch Plast Surg. 2016;43(1):3-10.

3. Hickey MJ, Samra JS. Umbilicoplasty: A review of techniques and outcomes. Plast Reconstr Surg Glob Open. 2020;8(7):e2891.

4. Lee ZH, Momeni A. Umbilicoplasty: Current trends and techniques. Aesthetic Plast Surg. 2019;43(2):297-303.

5. White CR, Rivera SC. Umbilicoplasty: An overview of indications and outcomes. Surg Clin North Am. 2018;98(5):1005-1013.