August 23, 2026 | Body Contouring, Plastic Surgery News
Nobody thinks about their belly button until it looks wrong. After a tummy tuck, or after any abdominal surgery, some patients end up with a navel that looks flat, scarred, or barely there. It is often the one thing a patient sees every time they look in the mirror.
A patient flew in to see me about exactly this not long ago. Rather than write around it, I pulled the answers straight from my consult dictation, identifiers removed. This is how the conversation actually went.
“Why does my belly button look flat?”
“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.”
That is the honest answer. Some patients simply never had much umbilical skin, and after surgery the navel heals flat instead of curving inward. The fix is a new umbilicus, built from the surrounding skin, sometimes with a little fat grafted around it for depth.
“They wanted you to look at the back. One of the scars is raised.”
“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?”
She said yes, just the raised part.
“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.”
“Not putting me out, right? We can still do it with local?”
Yes. Local anesthesia, awake the whole time. Adding the scar revision stretches the case: “It’ll probably take a little longer, probably about an hour.”
My exam note from that day reads: “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.”
Why Choose Dr. Agullo?
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and I teach plastic surgery as a Clinical Associate Professor at Texas Tech University Health Sciences Center. Revision work like this is about judgment in the small decisions: how much skin to move, whether fat grafting will add the right depth, when a scar needs revision instead of an injection.
Ready to Talk?
Call my office at (915) 590-7900, text the consult line at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
