title: How to reconstruct a natural and deep umbilicus: three methods of umbilicoplasty for five types of umbilical deformities.
abstract: 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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan. kajikawa@fmu.ac.jp
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kajikawa
authors.forename: Kazuki
authors.initials: K
authors.lastname: Ueda
authors.forename: Yoko
authors.initials: Y
authors.lastname: Katsuragi
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Kimura
authors.forename: Akiko
authors.initials: A
authors.lastname: Hasegawa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D014472:Umbilicus / Q000002:abnormalities* / Q000601:surgery*; D055815:Young Adult