Is umbilicoplasty something a plastic surgeon would typically be willing to perform on a minor? Our ten-year-old had an umbilical hernia as an infant, which resolved on its own. What remains appears to be just extra skin. She has been asking for years to have it "fixed." We are willing to entertain her wishes as long as the procedure requires only local anesthesia. Thank you.
What might be feasible under local anesthesia in an adult patient would likely not be on a child. It would be a very unusual 10 year old who would tolerate the procedure under local.
It is not that simple. It appears that she has a small hernia, that is, a small opening in the fascia. It is small and does not require fixing but it is the reason for the bulge. Most of these hernias in children reduce in size and do not require fixing but the small hole persists. To repair this it would require closing the small hole and perhaps removing or reshaping some of the skin. If she wants it that bad then she may tolerate a local anesthetic but It is going to be a lot harder to repair under these circumstances and even possibly not feasible. I would not do this under a local anesthetic or have my child undergo this under a local anesthetic as the result will be not as good and more traumatic for her. I certainly see her concerns ant they are legitimate. Take her to a local pediatric surgeon or ABPS certified physician for a consultation .
Outies suggest a hernia, especially if it should get firmer or larger when doing a sit up. At her age, it will not close on its own and if symptomatic, see a local general surgeon for confirmation of what it looks like. Those can be fixed with laparoscopic procedures to minimize scarring. If you can find a local plastic surgeon who can swoop in when she is under general, then the belly button can be reshaped then as well. Otherwise, once healed, she could have a umbilicoplasty done in the office if she is tolerant of needles and local anesthetic (older kids are). A plan would be determined by what she is left with after healing but belly buttons are common in my practice as I prefer to remove them during tummy tucks and make one months later. It just looks better.
From your given photo if you concern only umbilical hernia you may fixed with minor procedure but need full examination first. But if you have umbilical hernia with abdominal skin excess you may fix umbilical hernia while abdominoplasty together.