Superior positioning of the ptotic umbilicus in abdominoplasties and TRAM flaps.

The author finds that higher positioning of the umbilicus in cases of abdominoplasty and other similar operations such as transverse rectus abdominis musculocutaneous flap breast reconstruction is a useful technique. The operation renders better aesthetic results and also increases the margin of safety in lower abdominal flap circulation because tension is transferred from the lower abdomen to the upper abdomen. Technically, the procedure is easy to do and teach. The umbilicus is fixed to a higher point in the abdominal wall and the new umbilicus is reconstructed in a reasonably higher position with a safe degree of tension at the upper abdominal flap while trying to decrease tension in the lower part of the abdominal flap.