Reconstruction Of Umbilicus Research Articles

Aesthetic Evaluation and Validation: Umbilicus Reconstruction after DIEP Flap.

The most common method for autologous breast reconstruction is the deep inferior epigastric perforator (DIEP) flap. The umbilicus can be managed in various ways, including re-inset, neoumbilicus, and umbilectomy without reconstruction. This study evaluated the aesthetic differences in umbilicus reconstruction choice and variation in patients' postoperative satisfaction with their abdomen. A retrospective review of 1,019 patients treated with DIEP flap breast reconstruction between August 2009 and January 2022 was conducted. Patients were stratified by management of the umbilicus: preservation and re-inset of the native umbilicus, umbilectomy with delayed reconstruction, and umbilectomy with no reconstruction. A crowdsourced survey was created to assess the aesthetic preference of each photograph using a Likert scale. There were 1,063 responses to the umbilicus preference crowd source survey. Patients who had delayed umbilicus reconstruction after umbilectomy were rated to be significantly more attractive (4.397 ± 1.697) than both preservation of the native umbilicus (4.176 ± 1.669) and lack of the umbilicus (3.994 ± 1.733; p < 0.001 and <0.001, respectively). In an analysis of the BREAST-Q scores, delayed reconstruction patients had a similar change across measures when compared to the re-inset group. The delayed group had a significantly higher change in overall satisfaction and well-being with abdomen when compared with the no reconstruction group (p = 0.006 and 0.027, respectively). This study demonstrates that umbilectomy with delayed reconstruction yields a significantly higher aesthetic rating and comparable patient satisfaction when compared to re-inset of the umbilicus.

Umbilical Reconstruction Techniques: A Literature Review.

There are many instances in which sacrificing the umbilicus is unavoidable. Umbilical reconstruction (umbiliconeoplasty) is an important surgical procedure to complete the abdomen's reconstruction and to give again a pleasant cosmetic appearance. To provide a complete overview of all surgical techniques for umbiliconeoplasty described in the literature. PubMed database was queried using 'umbilical and reconstruction', 'umbilicus and reconstruction', 'navel and reconstruction', 'umbiliconeoplasty', 'neo-omphaloplasty' or 'umbilicaneoplasty' to select the papers dealing with the reconstruction of the umbilicus. Sixty different techniques for the reconstruction of the missing umbilicus were described in 77 papers. Local skin flaps and the purse-string suture technique were the most frequently described techniques. The Three flaps technique, the Four flaps technique and the 2 Lateral rectangular pedicle lateral flaps technique were the most popular local flap techniques. Indications ranged from congenital pediatric defects to reconstruction during abdominoplasty. Several surgical techniques were described for umbilicus reconstruction. While there is not a universal algorithm for the choice of the technique, the surgeon may decide which technique to use based on other surgeons' experiences reports. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Umbilicus Reconstruction with Bilateral Square "Pumpkin-Teeth" Advancement Flaps.

The creation of a neoumbilicus is a common challenge for plastic surgeons. The authors present their technique of umbilical reconstruction with bilateral square "pumpkin-teeth" advancement flaps. The technique described is applicable in both the setting of a vertical midline incision and when no midline incision is present (e.g., an abdominoplasty). The reconstruction has been performed in over 50 patients with a vertical midline incision and five patients without a midline incision. The only complications noted were persistent serous drainage in several patients with vertical incision and inadequate depth in one patient without a midline incision. This technique is quickly performed, and avoids small flaps, external incisions, and healing by secondary intention.

Intestinal perforation after surgical treatment for incisional hernia: iatrogenic or idiopathic?

Intestinal perforation (IP) is a life-threatening gastroenterological condition requiring urgent surgical care, which may present itself as an uncommon complication following incisional hernia repair surgery, most often because of iatrogenic traumatism occurring during the procedure. However, we report a case where a spontaneous onset can be hypothesised. A 60-years-old patient underwent repair of an abdominal laparocele, through rectus abdominis muscle plasty, 5 years after development of an incisional hernia due to exploratory laparotomy for the treatment of acute appendicitis. Xipho-pubic scar was excised and umbilicus and supra-umbilical hernia sac dissected, a linear median incision was performed along the sub-umbilical linea alba, reaching preperitoneal plane to assess any intestinal loop adherence to the abdominal wall. After limited viscerolysis, abdominal wall defect was corrected by ‘rectus abdominis muscle plasty’ and umbilicus reconstruction by Santanelli technique. Postoperative course was uneventful until Day 29, with sudden onset of epigastric pain, fever and bulge. Sixty cubic centimeter pus was drained percutaneously and cavity was rinsed with a 50% H2O2 and H2O V-V solution until draining clear fluid. Symptoms recurred two days later, while during rinsing presented dyspnoea. X-Ray and CT scan diagnosed IP, and she underwent under emergency an exploratory laparotomy, leading to right hemicolectomy extended to last ileal loops and middle third of the transverse, right monolateral salpingo-ovariectomy and a temporary ileostomy by general surgeon. Twenty-three days later an ileostomy reversal surgery was performed and 8 days after she was discharged. At latest follow-up patient showed fair conditions, complaining abdominal pain and diarrhoea, attributable to the extensive intestinal resection. IP following incisional hernia repair, is reported as uncommon and early postoperative complication. In our case, the previous regular postoperative course with late onset lead us to hypothesise a possible idiopathic etiopathogenesis, because of a strangulation followed by gangrene and abscess formation, which might begin before the incisional hernia repair and unnoticed at the time surgery was performed.

Improvement on the Neo-umbilicoplasty Technique and Review of the Literature.

The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty. To improve the technique of neo-umbilicoplasty, creating a deeper and more natural-looking umbilicus, and propose a reoperation technique for shallow umbilici. The sample consisted of 108 patients aged 25-67years submitted to abdominoplasty and scarless neo-umbilicoplasty under epidural anesthesia performed by the same surgeon and at the same hospital between July 2013 and October 2015. Follow-up lasted from 6 to 24months. The new umbilici were scarless. Many different techniques may be used to reconstruct the umbilicus. The main purpose is to create an adequately localized structure with a natural, youthful appearance and minimal scarring. To do so, we used ten (rather than six) attachment stitches and mobilized the adipose tissue toward the center of the new umbilicus to achieve greater depth, even in lean patients. Techniques which involve suturing the umbilical stalk onto the incised skin of the abdominal flap tend to produce unesthetic results, such as visible scars and umbilical skin islands of varying size. Scarless neo-umbilicoplasty does not require suture removal and poses no risk of dehiscence, secretion or umbilical stenosis, as observed with other techniques. The localization of the new umbilicus in the space between the rectus abdominis muscles, the use of ten rather than six stitches and the mobilization of the adipose tissue toward the periumbilical area constitute an improvement on the neo-umbilicoplasty technique. The resulting umbilici were scarless and very natural-looking. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Umbilicus Reconstruction After Melanoma Excision.

An 81-year-old woman was admitted with a nodular cutaneous melanoma of the abdominal wall involving the umbilicus. After performing wide excision with 2 cm margin of the melanoma, umbilical reconstruction and defect closure were planned. After careful consideration, we decided to use an island pedicle flap which allowed closure of the defect and reconstruction of the umbilicus.

DIEP Flap Technique for Umbilicus Reconstruction

This article describes a new perforator flap technique for reconstruction of the umbilicus. Previously described techniques for umbilicus reconstruction are not satisfactory because of their aesthetic limitations. Namely the need for incisions outside of the reconstructed umbilicus; limited depth of the reconstructed umbilicus; or reliance on skin grafting, which results in a scarred and contracted umbilicus. All of these limitations are eliminated by utilizing a perforator flap for umbilical reconstruction.

“Umbilicosliding” or Repositioning of the Navel during or after Abdominal Liposuction to Prevent or Correct the “Sad Umbilicus” Appearance

Introduction: The umbilical scar is the only scar that is culturally accepted and whose dysmorphia or absence catches people's attention. Studies have discussed numerous umbilicus reconstruction techniques but not any for repositioning the umbilicus during or after liposuction. In this study, we will introduce a technique called “umbilicosliding” that is used to prevent or correct a defect known as the “sad umbilicus” without visible scarring. Method: A retrospective study was conducted from 2010 to 2014 in which 32 patients fulfilled the inclusion criteria. Preoperative and postoperative photographs were analyzed by two plastic surgeons that were not on the team at the time of the procedures. Patients were recalled and surveyed about results. Results: The external assessment of aesthetic outcome by photographic results were 31% (n = 10) excellent, 47% (n = 15) good, 22% (n = 7) regular, and 0% bad. Recalled patients assessed the aesthetic outcome at 25% (n = 8) excellent, 66% (n = 21) good, 9% (n — 3) regular, and 0% bad.

One-Stage Umbilicus Reconstruction After Resection of Urachal Cyst

Umbilical reconstruction after total excision of the umbilicus represents a challenging problem for reconstructive surgeons. We describe herein a new method for one-stage umbilical reconstruction after resection of a urachal cyst. This case series included 6 patients, with laparoscopic urachal cyst removal in 5 and conventional transcutaneous surgery in 1. One-stage umbilical reconstruction was performed in all cases. When a conventional transcutaneous approach is indicated, umbilical reconstruction can be undertaken through the same skin incision used for total resection of the urachal cyst. Two triangular flaps were designed just below the umbilical defect. Flaps were rotated 180 degrees and sutured together to form one big triangular flap. This flap was then folded to create the new umbilicus. A deep umbilicus with good shape was constructed in all cases, and all patients were satisfied with the outcome. This method is simple, easy, and produces a natural-looking umbilicus.

Neo-onfaloplastia na dermolipectomia abdominal: técnica do duplo "V"

INTRODUÇÃO: Este trabalho tem como finalidade a reconstrução ou o reimplante do umbigo durante a cirurgia de dermolipectomia abdominal. MÉTODO: Através do isolamento do umbigo antes da dermolipectomia, realiza-se uma incisão triangular e reimplante deste com incisão em "V" no retalho abdominal final e confecção de uma peça em "V" do umbigo anteriormente isolado. RESULTADOS: Observa-se perfeita coaptação destas bordas confeccionadas, situando-se a cicatriz umbilical na parte interna do neoumbigo, permitindo, assim, melhora estética do umbigo. CONCLUSÃO: Observou-se que, em sua totalidade, o resultado demonstrou harmonia e evitou-se a retração umbilical constritiva pós-cicatricial tão comum nas técnicas circulares ou em fenda.

A New Method for Umbilicus Reconstruction: Preliminary Report

The umbilicus is a very important component of the abdominal aesthetic view. However, loss of the umbilicus for any reason is a challenging problem. Various methods for umbilicus reconstruction have been published. Most of these methods are complex, and the surgical outcome is mostly unsatisfactory for the patients. The authors have developed a simple method for umbilicus reconstruction using a bilobed flap.

Reconstruction of a natural-appearing umbilicus using an island flap: case report

A case of successful reconstruction of the umbilicus using a depressed scar in an 11-year-old girl with a large and rigid scar spreading around the centre of the abdominal wall is presented. The anatomical umbilicus was replaced by a large scar after a previous surgery for umbilical cord hernia. The difficulty of the conventional method compelled us to use a distant scar dimple as an island flap. In addition, the three-dimensional morphology of the umbilicus could be reproduced by rolling a spindle island flap into a cone. Postoperatively, the reconstructed umbilicus has remained deep and aesthetically well shaped.

Umbilicus reconstruction with modified ‘unfolded cylinder’ technique

Many techniques have previously been reported for reconstruction of the umbilicus. The common goal of reconstruction is to obtain a stable and aesthetically pleasing umbilicus with sufficient depth. Presented here is the reverse application of an 'unfolded cylinder' design, which has previously been reported for nipple reconstruction. The procedure can be applied with local anaesthesia on an outpatient basis and the drawing of the design is simple. Since the walls of the neoumbilicus are consisted of flaps, which are brought together without any twisting or tension, long-term use of a stent is unnecessary and the result is mostly stable and lasting. Moreover, the depth of the neoumbilicus is adjustable by widening the top rectangle in its design, which can increase it. Therefore, the procedure is suitable for thin as far patients.

Reconstruction of the umbilicus: a simple technique.

The author proposes a simple technique for umbilical reconstruction. The new umbilicus is represented by an island flap that is sunken and then sutured to a circular skin defect drawn at the intersection of the xiphoid-pubic line and the transverse umbilical line. Before sinking, an accurate excision of the subcutaneous fat of the skin island is performed. A natural-looking elliptical scar is obtained, without any additional scar and providing good aesthetic results. The technique proposed can provide a good alternative to existing umbilicus reconstruction techniques.

Reconstruction of the Umbilicus Using a Single Triangular Flap

Many techniques for reconstruction of an absent umbilicus have been described; however, none has achieved a perfect result. We report a new alternative for constructing an umbilicus using a conical flap and present two representative clinical cases. Our technique creates an umbilicus with sufficient depth with good results, including maintenance of depth after more than 1 year.

Reconstruction of umbilicus during functional closure of bladder exstrophy

In babies born with bladder exstrophy, the umbilicus is caudally displaced, and attached to the upper margin of the exstrophied bladder. Reconstructive surgery often removes the navel. A surgical technique for preservation and repositioning of the umbilicus is presented.

Reconstruction of umbilicus in bladder exstrophy: M.K. Hanna and K. Ansong. Urology 24:324–326, (October), 1984

Reconstruction of umbilicus in bladder exstrophy: M.K. Hanna and K. Ansong. Urology 24:324–326, (October), 1984

Reconstruction of umbilicus in bladder exstrophy

A surgical method for reconstruction of the umbilicus in patients with bladder exstrophy is described. The technique is based on the surgical principle of eventual tubularization of a skin strip buried in the subcutaneous space.

Reconstruction of the Umbilicus by a Double V—Y Procedure

Reconstruction of the Umbilicus by a Double V—Y Procedure

Reconstruction of the Umbilicus in Abdominoplasty

Reconstruction of the Umbilicus in Abdominoplasty