A patient flew into El Paso recently to ask Dr. Frank Agullo about two things that had bothered her since a prior surgery: a belly button that healed flat, and a raised scar on her lower back. Seven minutes of consult dictation answered both. We are publishing the exchange nearly as it happened, identifiers removed, because patients keep asking the same questions.

Patient: Why does my belly button look flat?

Dr. Agullo: “When I went in, there was very little skin. I have to make it like a new one from scratch. This is the only skin you had, the tiny bit in the middle. It’s the only skin you had that was actually the belly button. So I have to bring in this to make it look in, and so we don’t see a scar. And I think it’s gonna look a lot better.

“And then depending on how it heals, or even during the surgery, sometimes I put a little bit of fat around it so it gives it more of a depth. So we can start planning. It should only be probably about a thirty, forty-five minute procedure.”

Patient: They wanted you to look at the back. One of the scars is raised.

Dr. Agullo: “So there’s two choices here. It’s like a hypertrophic scar. So one is to put steroid in it. It’ll make it flatter, but it’ll probably make it wider. The other one is just to do a revision, do this area here and then re-suture it, and it should heal better because there won’t be as much tension as the first time. That will probably give you a better-looking scar in the end. Is this the part that you’re most concerned with, the part right here?”

Patient: Yeah, just the raised part.

Dr. Agullo: “I think if we do the steroid, it will be flat, but it will get wider. So I think it’s gonna look better if we actually do the revision, and since we’re gonna be doing something anyway, we could just do the back at the same time.”

Patient: Not putting me out, right? We can still do it with local?

Dr. Agullo: “It’ll probably take a little longer, probably about an hour.”

Both procedures, one visit, local anesthesia only. His exam note from that day: “Patient doesn’t have much belly button skin, so it looks flat. We will have to do a new umbilicus with possibly some fat grafting, and revision of the hypertrophic scar in the back and the coccyx area.”

The takeaway

A flat or scarred navel after a tummy tuck or other abdominal surgery is fixable. On its own it is a thirty to forty-five minute procedure. Paired with a scar revision, about an hour. For the right patient, no general anesthesia at all.

Dr. Agullo is a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and a Clinical Associate Professor of plastic surgery at Texas Tech University Health Sciences Center.

Ready to Talk?

Call Southwest Plastic Surgery at (915) 590-7900, text the consult line at 1-866-814-0038, or book a consultation at swplasticsurgery.com.

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