Umbilical reconstruction with the bow tie flap

The umbilicus can be absent in congenital malformations that are associated to umbilical agenesia such as bladder exstrophy, gastroschisis or omphalocele or it can be excised during surgical procedures such as umbilical herniorrhaphy, abdominoplasty and laparotomy. We report a new technique for umbilical reconstruction, using a “bow tie”-shaped flap, partially made of scar tissue. We treated three female patients with absent umbilicus as a consequence of congenital malformations or previous surgical treatments. This method provided a good conical shape to the neoumbilicus with adequate depth and a wide external ring. Follow-up at 2 years showed that a satisfactory shape was maintained. Previously described techniques for neoumbilicoplasty were unsatisfying or seemed too complex in our hands. The reported technique is easy and simple, with good, stable and natural aesthetic results, and it can be effectively used for umbilical reconstruction in all primary or secondary cases of umbilical absence.