ABSTRACT
Loss of the umbilicus can result in an embarrassing deformity. Acquired loss can result from some older techniques of umbilical hernia repair (1) as well as from tissue necrosis complicating modern breast reconstruction based on the lower abdominal tissue. The umbilicus is the only structure normally found in the otherwise smooth and featureless skin of the mid abdomen. The ideal umbilical reconstruction creates a permanent, rounded depression in the mid abdomen with a minimum of scarring. The superior margin should form a slight hood of skin. Techniques described for umbilical reconstruction use various flaps (2-7) sometimes in combination with tissue grafts (8). Most of these are delayed reconstructions that are designed on an intact, smooth abdominal surface. Immediate reconstruction presents a slightly different problem in that more tissue is required which must be recruited from a greater distance. The ‘‘iris’’ technique described below satisfies this need by borrowing tissue from all directions.
