do we really need a belly button

It seems like yesterday I was sitting in the plastic surgeons waiting room while my girlfriend JoAnne underwent the second of her three planned reconstructive procedures; a lower body lift, medial & lateral thigh life and upper arm lift.

At noon, we entered the pre-surgical suite and within a few minutes the anesthesiologist (not a nurse anesthesiologist, but an M.D.), started her IV. Then Jo, a beautiful 68-year-old who was in love with her new slimmer and much healthier life, gave me a hug and shuffled into the operating room. She was then in the strong and capable hands of a top plastic surgeon in the specialty of post gastric bypass reconstruction. Surgeons like Dr. Bernard Shuster understand skin challenges that remain after a loss of 100 pounds or more and have perfected techniques to not only safely remove excess skin, but also leave a pleasing result. These are technically difficult procedures often requiring extensive reconstruction as the surgeons are not starting with a smooth or blank canvas. Dr. Shuster is one of a select group of surgeons playing an integral role in our recovery by providing not just ordinary, but outstanding surgical results for post operative bariatric patients.

I remember an old message board thread from a gastric bypass post-op who had gone for a plastic surgery consult. She was upset that the doctor told her that she wouldn’t have a belly button after her tummy tuck procedure as he didn’t ‘do’ bellybuttons. This bothered her and she asked for opinions and support. She actually felt silly and ungrateful for wanting to have a belly button after her tummy tuck! As I read the first 15 or so responses, I could feel my eyebrows begin to rise and fingers itch for my keyboard as there was not one post that encouraged her to find another surgeon for another opinion. All the replies to her post encouraged her to be happy that her insurance was going to cover her surgery, be satisfied that she was going to be rid of the large skin flap, and chided her for mourning the loss of her useless belly button.

I clenched my teeth as I contemplated the mindset of these folks who didn’t understand that they were the customer and that they got to approve or reject the planned result. They didn’t realize that they should shop around and compare attitudes. That even though this was plastic surgery, that it was still an operation and that they should expect at least reasonable results.

No belly button? This doesn’t even make sense. How can a plastic surgeon worth their degree not be able to leave a patient with an intact belly button? More importantly, why wasn’t anyone else upset about this? When you have a tummy tuck or abdominoplasty, your belly button isn’t moved; the skin around it is. The surgeon first makes a horizontal incision between your belly button and pubic hairline; cuts around your belly button (known as your umbilicus), loosens the surrounding belly skin, pulls down the excess skin and then cuts a hole in the skin so your belly button can once again peek through. So it is never detached – it stays put while the surrounding area is manipulated. So basically, an experienced plastic surgeon leaves you with a belly button – in fact, the same one you started out with. While I cannot say we are all left with an attractive belly button even with the best of plastic surgeons, at least we have one. (perhaps new technique is needed to be discovered and shared so we don’t end up with those odd bullseyes)

We need to be educated consumers when it comes to medical procedures. We agonize over buying a vacuum cleaner or a blender, but don’t investigate a gastric bypass surgeon or plastic surgeon because they happen to be listed in our insurance book. There are surgeons, good surgeons, and great surgeons; based on the numbers of procedures they perform, technique, schooling, innate capability, and results. Find a surgeon who is practiced in dealing with large amounts of excess skin. This is an art and a surgeon who is gifted in this art, barring unforeseen circumstances, leaves you with a belly button. (although there is a Victoria’s Secret Angel who does not have a belly button and it is said they photoshop one so the photos do not look strange) While I am on a roll, great plastic surgeons do close your incision with staples. Plastic surgeons are proud of their delicate nearly invisible perfect stitches. This is a hallmark of plastic surgery. Now this is just my opinion, but you would have to be out of your mind to allow a plastic surgeon to staple your abdominoplasty incision. Maybe (just maybe) if you were having extensive reconstructive procedures requiring several feet of incisions, this might justify staples. For the average tummy tuck, it is not acceptable and I would leave the office of any surgeon suggesting such.

Did you know that any doctor who practices in any medical specialty can decide he is going to start doing brow lifts or even breast augmentations starting next Wednesday. Make sure who you chose for your surgery is board certified in the specialty of Plastic Surgery and make they also specialize in the procedure you are having done. Ask the surgeon directly how many tummy tucks, or thigh lifts, or body lifts they perform each month… each week. How many are on people who have lost 150 pounds? Do you really want someone who has never done an arm lift (called a brachioplasty), doing his first one on on you? This is not a procedure to be taken lightly – I know a bariatric post op who has pain holding up her arms to drive because of poor technique used by a surgeon who had never done a brachioplasty before. Her scars are thick ropes extending into her armpits that compromise function, but just as bad is that they are visually disturbing.

Doing a tummy tuck on someone who has a little flab after having a baby is very different from reconstructing an 11 pound skin flap after a 219 pound weight loss. Don’t choose a plastic surgeon who has never done a medial thigh lift – this is not a common procedure and poor outcome can affect your life. We have all heard that practice makes perfect but studies prove it is true. Choose someone who is practiced in the procedure you want or need.

Ask questions, don’t be intimidated, ask to see actual photos of the surgeons patients so you can see how his procedures turn out, and please do not think for a moment that you should settle for what you can get because you are using an insurance benefit.

Stellar examples of plastic surgeons who specialize in bariatric patient skin removal are Dr. Bernard Shuster of Hollywood, Florida, Dr. Alan Pillersdorf of Palm Beach, Florida and Dr. Timothy Katzen of Beverly Hills, California. I have linked their websites below and adore these men for their dedication to helping us! Plus maybe we should tell the Victoria’s Secret Supermodel Angel that all three of these fine surgeons do belly buttons!

A last thought… please, please, before you have that plastic surgery, STOP SMOKING, take your vitamins, and use plenty of protein so your body can heal. Plan for your surgical success and do everything you can to help your surgeon achieve the beautiful result you deserve.


Link to Dr. Bernard A. Shuster website Make sure you check out his online secure photo consultation service. The doctor will speak with you personally. Dr. Shuster has turned out some of the best looking post-brachioplasty arms I have seen – amazing results for a difficult procedure.

Link to Dr. Alan Pillersdorf website – A fine surgeon who is practiced in post bariatric procedures.

Link to Dr. J. Timothy Katzen website I have known Dr. Katzen for many years; I know many of his satisfied and very happy patients.