Kajikawa Akiyoshi, Ueda Kazuki, Katsuragi Yoko, Kimura Shinnosuke, Hasegawa Akiko
Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan.
Ann Plast Surg. 2012 Jun;68(6):610-5. doi: 10.1097/SAP.0b013e3182198c27.
Conventional methods of umbilicoplasty using V-Y advancement flap often result in unnatural wide or shallow umbilical depressions facing upward or downward. Moreover, although the umbilical deformities have many variations, no report has described the selection of an umbilicoplasty method for types of umbilical deformity. To resolve these problems, we devised 3 methods of umbilicoplasty. In this report, we classified all kinds of umbilical deformities into 5 types, and studied the most suitable method for each type of umbilical deformity.
The umbilical deformities are classified into Type 0: the defect of umbilicus; Type I, the low-grade protrusion; Type II, the high-grade protrusion with wide base; Type III, the high-grade protrusion with narrow base; and Type IV, the protrusion in depression. The most suitable method among our 3 methods was adapted to each type. Method 1 with a S-shaped skin incision was adapted to Type 0 and I, Method 2 with fan-style flaps was adapted to Type II, and Method 3 with dividing the umbilical protrusion was adapted to Type III and IV.
Sixty-three patients (10 cases of Type 0, 31 cases of Type I, 10 cases of Type II, 5 cases of Type III, and 7 cases of Type IV) underwent umbilicoplasty using the suitable method, and all were well corrected.
Using the best choice among our 3 methods, it is easy to create a natural, vertically long and deep umbilical depression without conspicuous scars in all types of umbilical deformities.
传统的采用V-Y推进皮瓣的脐成形术方法常常导致脐部出现不自然的宽而浅的凹陷，且凹陷向上或向下。此外，尽管脐部畸形有多种变化形式，但尚无报告描述针对不同类型脐部畸形选择合适的脐成形术方法。为解决这些问题，我们设计了3种脐成形术方法。在本报告中，我们将各种脐部畸形分为5种类型，并研究了每种类型脐部畸形最适合的方法。
脐部畸形分为0型：脐部缺损；I型，轻度突出；II型，宽基底重度突出；III型，窄基底重度突出；IV型，凹陷内突出。我们的3种方法中最适合的方法适用于每种类型。方法1采用S形皮肤切口，适用于0型和I型；方法2采用扇形皮瓣，适用于II型；方法3采用将脐部突出部分分开的方式，适用于III型和IV型。
63例患者（0型10例，I型31例，II型10例，III型5例，IV型7例）采用合适的方法进行了脐成形术，所有患者均得到良好矫正。
采用我们3种方法中的最佳选择，在所有类型的脐部畸形中都能轻松形成自然、垂直长且深的脐部凹陷，且无明显瘢痕。
