Belly buttons have always been an afterthought when it comes to tummy tucks, but this tiny detail has become one of the defining markers of quality and craftsmanship in cosmetic surgery. The “perfect innie” has become the ultimate finishing touch on a flat, sculpted abdomen in post-surgery reveals and an increasingly hot topic on social media feeds.
Reality TV personality Nozipho Ntshangase, who has been open about her mommy makeover journey, recently sparked conversation after sharing a glimpse of her natural-looking results. Credited for her naval reconstruction was Prof Chrysis Sofianos, who says the online excitement about Ntshangase’s results mirrors a broader trend in aesthetic medicine, where many patients favour subtle, natural-looking enhancements over dramatic transformations.
“Today’s patients want to look like themselves, only more refined. The belly button may seem like a small detail, but it’s the visual anchor of the abdomen. When it’s shaped and positioned perfectly, everything feels balanced and proportionate — it completes the story in an authentic way.”
Tummy tucks, also known as abdominoplasties, have become increasingly popular in South Africa, with demand steadily rising as more women seek post-pregnancy body restoration solutions.
But while attention often centres on the flatness of the stomach or tightness of the skin, Sofianos emphasises the navel’s placement and shape can make or break the aesthetic outcome. “If it’s too high, too low or unnaturally round, even an otherwise flawless tummy tuck can look off. A well-crafted belly button looks effortless, like it’s always belonged there.”
He says repositioning the navel is one of the most technically demanding parts of a tummy tuck, and when things go wrong, the consequences can be serious.
One of the most severe complications is tissue necrosis, where the navel loses its blood supply and the tissue dies, sometimes requiring reconstructive surgery. Poor abdominal-wall repair can further cause umbilical hernias, producing painful bulges that may necessitate further surgeries. Additionally, a misaligned or puckered navel can interfere with healing, create visible scarring and compromise core-muscle function, contributing to back pain and posture issues later.
“These are preventable complications, but surgical experience and knowledge are crucial. When experience or attention to detail is lacking, even a millimetre miscalculation can change the entire outcome.”
Sofianos explains that meticulous technique and anatomical knowledge are essential for preserving the navel’s natural blood supply and contour.
“The belly button is small, but it’s also symbolic. It sits at the centre of the abdomen, which is the focal point of the body’s symmetry. A well-executed reconstruction blends science and artistry. When it fails, it’s immediately obvious.”
For patients considering a tummy tuck, he therefore recommends thorough vetting. “Choose an HPCSA-registered plastic surgeon with proven reconstructive experience. Plus, always review before-and-after images that show the navel — it can reveal a surgeon’s precision more than any other detail.”
A) The umbilicus in image A is circular and centrally positioned, with a fine, light and well-healed scar visible circumferentially. Though the contour is natural, it does not employ the hidden umbilicus technique, and the scar remains visible all around the border.
B) Image B demonstrates the hidden umbilicus technique, where the scar is recessed and largely concealed within the shadow of the navel. However, the pigmentation is dark, making the scar more apparent than desired, despite the superior concealment.
C) The umbilicus in image C shows a raised, hypertrophic scar, indicating an overactive healing response and excess collagen formation. The contour appears distorted, and the texture is less refined.
The ideal result would combine the characteristics of A and B — a fine, well-healed, lightly pigmented scar (as in A) together with the recessed, concealed placement of the hidden umbilicus technique (as in B).