Umbilicoplasty is a cosmetic operation that reshapes the skin of the belly button, for example turning an outie into an innie or tightening a stretched navel, whereas an umbilical hernia repair closes a weakness in the abdominal wall through which fat or bowel is pushing. An outie can be either, so the first step is always an examination, and sometimes an ultrasound scan, to find out whether a hernia is present.
Anatomy of the belly button
The belly button, or umbilicus, is the scar left where the umbilical cord was attached. Beneath the skin, the abdominal wall has a small natural weak point at this site. In most people it closes firmly in early childhood and the navel sits inward. Its final shape depends on how the cord stump healed, the thickness of the surrounding fat and the strength of the abdominal wall. Pregnancy, weight change and ageing can all alter its appearance later in life.
What an umbilical hernia is
An umbilical hernia occurs when fatty tissue or part of the bowel pushes through the weak point in the abdominal wall at the navel. It often appears as a soft bulge that becomes more obvious when coughing, straining or standing and may flatten when lying down. Hernias can develop after pregnancy, with weight gain or with heavy lifting. Some cause no symptoms; others ache. A hernia that becomes suddenly painful, firm, discoloured or cannot be pushed back, especially with vomiting, needs urgent medical attention through A&E or 999, as the tissue may be trapped.
Why an outie is not always a hernia
Many outie belly buttons are simply excess skin or scar tissue from the way the cord healed, with a perfectly strong abdominal wall beneath. Others contain a small hernia. The two can look similar, which is why a clinical examination matters. Mr Nassab will feel for a defect in the abdominal wall and, if there is doubt, arrange an ultrasound scan before any cosmetic plan is made.
How the operations differ
- Purpose: Umbilicoplasty: cosmetic reshaping of the navel skin. Hernia repair: closing a defect in the abdominal wall to treat or prevent symptoms.
- What is repaired: Umbilicoplasty: skin and the connection between navel skin and abdominal wall. Hernia repair: the muscle and fascia layer, sometimes reinforced with mesh.
- Anaesthetic: Umbilicoplasty: often local anaesthetic. Hernia repair: frequently general anaesthesia.
- Specialist: Umbilicoplasty: a plastic surgeon. Hernia repair: usually a general surgeon, although a small defect may be closed during cosmetic abdominal surgery.
- Recovery: Umbilicoplasty: desk work within days. Hernia repair: typically a longer restriction on heavy lifting.
- Funding: Umbilicoplasty: private, as a cosmetic procedure. Hernia repair: may be available on the NHS when medically indicated.
When the two are combined
If a small hernia is found alongside a cosmetic concern, the defect may be closed at the same time as the navel is reshaped, or the hernia may be treated first by a general surgeon with cosmetic reshaping later. Where there is loose skin or separated stomach muscles after pregnancy, a tummy tuck, which reconstructs the belly button as part of the operation, may address everything together. The right sequence depends on the size of the hernia and your wider goals.
Which is right for you?
If your outie is soft, grows when you cough and aches, a hernia assessment is the priority, and your GP is a good first port of call. If the bulge is simply skin, a hooded navel or a stretched shape, and the abdominal wall is intact, umbilicoplasty can reshape it. Many people need a combination of assessment and advice before the right route becomes clear. An umbilical lift costs from £1,250 and the £150 consultation fee is charged separately. Cosmetic surgery is for adults aged 18 and over.
Frequently Asked Questions
How can you tell if an outie is a hernia?
A bulge that enlarges when you cough or strain and shrinks when you lie down suggests a hernia, but only an examination, sometimes with an ultrasound, can confirm it.
Can an umbilicoplasty fix a hernia?
A cosmetic umbilicoplasty alone reshapes the skin and does not repair the abdominal wall. A small defect may be closed at the same operation if identified beforehand.
Will an umbilical hernia go away on its own?
In adults, umbilical hernias do not usually close by themselves. Small, painless hernias are sometimes monitored; your GP or a general surgeon can advise.
Is hernia repair available on the NHS?
Hernia repair can be available on the NHS where it is medically indicated. Purely cosmetic belly button reshaping is not usually funded.
Which symptoms need urgent help?
A hernia that becomes suddenly painful, hard, discoloured or cannot be pushed back, particularly with vomiting, needs urgent assessment through A&E or 999.
