A novel technique for flat umbilicus repair in abdominoplasty: bipolar fan-shaped incision and folded suture using paraumbilical flaps.

BACKGROUND

The umbilicus plays a pivotal role in abdominal aesthetics, and its reconstruction is essential for achieving a natural and deep appearance that aligns with patients' aesthetic expectations. However, traditional abdominoplasty has shown limitations in umbilical reconstruction for patients with a flat umbilicus, often resulting in unsatisfactory aesthetic outcomes.

OBJECTIVE

This study aims to introduce a novel umbilical reconstruction technique, enabling it to create a three-dimensional, stable and aesthetically pleasing navel in patients with a flat umbilicus, so as to improve the overall aesthetic outcomes of abdominoplasty.

METHODS

From November 2024 to November 2025, a bipolar fan-shaped incision folded and suture technique was employed in 24 female patients. Specifically, fan-shaped incisions were made at the superior and inferior poles of the umbilical stalk. Following the excision of a moderate amount of tissue, the remaining skin flaps were folded and sutured to construct a three-dimensional umbilical fossa.

RESULTS

This technique is straightforward to perform and has been successfully applied in 24 cases of patients with a flat umbilicus. Postoperatively, the umbilical morphology appeared deep, three-dimensional, and demonstrated stability. Overall, 87.5% (21/24) of patients were highly satisfied with the umbilical appearance, 8.3% (2/24) were satisfied, and only 4.2% (1/24) reported neutral satisfaction due to hypertrophic scars at the superior and inferior poles of the umbilicus. No complications such as umbilical stenosis or skin flap necrosis occurred after the surgery.

CONCLUSION

The bipolar fan-shaped incision folded and suture technique is an effective method for reconstructing a flat umbilicus during abdominoplasty. In this series of 24 patients, the technique demonstrated a high satisfaction rate and achieved a three-dimensional umbilical appearance with concealed scarring in the short term.