Reconstruction of a deformed umbilicus with a keloid using a single triangular incision line: a case report

Abstract

A common goal in reconstructing the umbilicus is to achieve an aesthetically pleasing result. This single-subject study demonstrates the outcome of managing an umbilical keloid scar using a single excisional line. A patient presented with a large, oval keloid scar at the center of his abdomen. The scar, measuring 4×3 cm in diameter, was deformed to the extent that it completely obscured the umbilicus. The patient frequently experienced intermittent inflammation at the site of the scar. We planned a triangular incision around the keloid. The umbilical keloid was excised and reconstructed using a flap anchored along the lower edge of the triangle. The triangular flap was elevated and the deep dermis of its cephalic portion was attached to the linea alba. The remainder of the flap was sutured at the center to create a conical shape. Eleven months post-procedure, the umbilicus maintained an aesthetically pleasing appearance with proper depth, superior hooding, and a concave shape without protrusion. An advantage of this straightforward surgical method is that it allows for simultaneous resection and reconstruction without the need for additional flap design. This method is expected to be a useful option for reconstructing umbilical keloids the size of a fully developed umbilicus.