Immediate Neoumbilicoplasty Following Excision of a Symptomatic Umbilical Lipoma Using Local Tissue Rearrangement and Fascial Fixation: A Case Report.

Umbilical tumors are uncommon and may present with pain, progressive enlargement, cosmetic deformity, and diagnostic uncertainty. Although lipomas are among the most common benign soft-tissue tumors, symptomatic lipomas involving the umbilical region and requiring excision with immediate reconstruction are rarely reported. A 43-year-old woman presented with a progressively enlarging, painful, nodular, and hyperpigmented umbilical lesion associated with distortion of the native umbilical anatomy. The clinical appearance raised concern for a melanocytic malignancy, including melanoma, prompting complete en bloc excision for definitive histopathological evaluation followed by immediate neoumbilicoplasty using a standardized geometric preoperative design, local tissue rearrangement, and deep fascial fixation to recreate umbilical depth and contour. According to the official pathology report, histopathological examination confirmed a benign lipoma without evidence of atypia or malignancy. Postoperative recovery was uneventful, without infection, necrosis, wound dehiscence, or recurrence. An umbilical conformer was used postoperatively in conjunction with abdominal compression to provide external support during scar maturation. At six-month follow-up, the neoumbilicus demonstrated preserved depth and contour, satisfactory scar maturation, and a favorable aesthetic result, with the patient reporting high satisfaction with the reconstructed umbilicus. This case illustrates that immediate neoumbilicoplasty using local tissue rearrangement and deep fascial fixation may represent a practical reconstructive option following excision of selected benign umbilical lesions and highlights the value of structured surgical planning when excision compromises the native umbilical anatomy.