Documente Academic
Documente Profesional
Documente Cultură
DOI 10.1007/s00266-014-0434-z
ORIGINAL ARTICLE
AESTHETIC
Abstract
Introduction The navel contributes to abdominal surface
identity and beauty. In Western societies, the display of the
navel in womens fashion has grown and, nowadays,
women are much more concerned about its shape and
position. Despite this, few studies are available on navel
surface anatomy and there is no standardization regarding
its proper placement in cosmetic abdominoplasty.
Materials and Methods In this observational study, we
analyzed navel shape and position on 81 high quality pictures, having been chosen as top 2013 bikini models by
editors of mass media. An on-line survey on navel shape
and position has been made via facebook.com, involving
1,682 people.
Results The analysis revealed that navel position is quite
variable based on the proportions analyzed with an acceptable narrow data spread of the xiphoidumbilicus:umbilicus-abdominal mean crease ratio of 1.62 0.16. The data
dispersion for the other three ratios was wider, making them
This work has been presented in part at the ASAPSThe Aesthetic
Meeting 2014, April 2429, 2014, San Francisco, CA, USA and at the
25th EURAPS Meeting, May 2931, 2014, Lacco Ameno, Isle of
Ischia, Italy.
G. Visconti M. Salgarello
Department of Plastic and Reconstructive Surgery, Universita`
Cattolica del Sacro Cuore University Hospital A.
Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy
G. Visconti (&)
Via Pietro Adami, 22, 00168 Rome, Italy
e-mail: joevisconti@hotmail.com
E. Visconti L. Bonomo
Department of Bioimages and Radiological Sciences, Universita`
Cattolica del Sacro Cuore University Hospital A.
Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy
Introduction
At the time of birth, the umbilical cord is cut, leaving a
stump which dries, heals, and falls within the first
48 weeks. The resulting scar is the umbilicus, which
represents the first unique physiologic scar of human life.
This structure is usually depressed and measures between
123
123
(B)
(C)
123
123
Results
Part AAnalysis of Navel Surface Anatomy in 81
Natural Top Bikini Models in 2013
Statistical analysis results (mean SD) of the four proportions measured in Part A are shown in Table 1.
The analysis revealed that navel position is quite variable based on the proportions analyzed. However, there is
an acceptable narrow data spread of the XC:UC ratio mean
(min 1.11, max 2.31, mean 1.62), with the standard deviation being 0.12. The mean value of 1.62 can be very
acceptably approximated to the golden ratio (i.e., 1.618).
The data dispersion for pelvic bony landmark ratios (i.e.,
interASIS:UC, interASIS:interASIS-U, and interASISU:interIC-U) is wider, with the standard deviation being
0.35, 0.74, and 1.92, respectively. Because of these wider
data spreads, these three ratios can be considered less
reliable than the XC:UC ratio as references (Fig. 5).
Part BAnalysis of Navel Shapes in 81 Natural Top
Bikini Models in 2013
The 81 navels analyzed can be classified into 6 different
shape categories, according to the classification of Craig
Table 1 Table showing results (mean standard deviation, minimum and maximum values) of the four proportions analyzed (navel
position) and of the vertical to horizontal navel ratio
Ratio
Mean standard
deviation
XU:UC
1.62 0.12
interASIS:UC
2.04 0.35
interASIS:interASIS-U
3.07 0.74
interASIS-U:interIC-U
2.87 1.92
vertical to horizontal
navel
1.30 0.46
Discussion
Since the first historically relevant report by Vernon in
1957 [1], almost every author reporting his/her abdominoplasty technique has usually provided a personal omphaloplasty technique. This resulted in a large number of
different incision patterns to relocate the navel. The aim of
the different omphaloplasty techniques is to obtain a
pleasant navel shape and to minimize scarring.
However, minimal attention has been focused on navel
positioning. Besides placing it along the abdominal midline, the omphaloplasty is usually performed on the navel
stalk projection in a neutral position on the abdominal
superior flap once this is advanced and temporarily fixed to
the pubic skin [2, 3]. Other authors, contrarily, prefer to use
123
123
Conclusions
The observational study of 81 worldwide recognized top
bikini models for 2013 reveals that, besides being midline,
the most attractive navel position is located at the XU:UC
golden ratio. Abdominal aesthetic unit analysis is suggested for proper navel positioning, as pelvic bony landmarks are not reliable references. The use of the Fibonacci
(golden mean) caliper intraoperatively might aid in the
proper positioning of the navel in abdominoplasty.
The vertical oval shape, the presence of superior hooding, and the absence of protrusion are the main features
that make a navel attractive for human eyes, confirming
conclusions from other navel shape studies.
Conflict of interest None of the authors has a financial interest in
any of the products, devices, or drugs mentioned in this manuscript.
123
References
1. Vernon S (1957) Umbilical transplantation upward and abdominal contouring in lipectomy. Am J Surg 94(3):490492
2. Pitanguy I (1975) Abdominal lipectomy. Clin Plast Surg
2(3):401410
3. Baroudi R (1975) Umbilicoplasty. Clin Plast Surg 2:431
4. Hinderer UT (1975) The dermolipectomy approach for augmentation mammaplasty. Clin Plast Surg 2(3):359369
5. Dubou R, Ousterhout DK (1978) Placement of the umbilicus in
an abdominoplasty. Plast Reconstr Surg 61(2):291293
6. Craig SB, Faller MS, Puckett CL (2000) In search of the ideal
female umbilicus. Plast Reconstr Surg 105:389
7. Sakamoto Y, Kamagata S, Hirobe S, Hayashi A (2010) Umbilical
shape by age and growth: a Japanese study. Plast Reconstr Surg
126(2):97e98e
8. Choudhary S, Taams KO (1998) Umbilicosculpture: a concept
revisited. Br J Plast Surg 51:538
9. Rohrich RJ, Sorokin ES, Brown SA, Gibby DL (2003) Is the
umbilicus truly midline? Clinical and medicolegal implications.
Plast Reconstr Surg 112(1):259263
123
10. Abhyankar SV, Rajguru AG, Patil PA (2006) Anatomical localization of the umbilicus: an Indian study. Plast Reconstr Surg
117(4):11531157
11. Parnia R, Ghorbani L, Sepehrvand N, Hatami S, Bazargan-Hejazi
S (2012) Determining anatomical position of the umbilicus in
Iranian girls, and providing quantitative indices and formula to
determine neo-umbilicus during abdominoplasty. Indian J Plast
Surg. 45(1):9496
12. Matarasso A, Wallach SG (2001) Abdominal contour surgery:
treating all aesthetic units, including the mons pubis. Aesthet
Surg J. 21(2):111119
13. Mendieta CG (2011) Evaluation based on anatomic landmarks.
In: Karen B (ed) The art of gluteal sculpting. Quality Medical
Publishing Inc., St Louis, pp 3109
14. Levin EI (1978) Dental esthetics and the golden proportion.
J Prosthet Dent 40(3):244252
15. Bruekers SE, van der Lei B, Tan TL, Luijendijk RW, Stevens HP
(2009) Scarless umbilicoplasty: a new umbilicoplasty technique and a review of the English language literature. Ann Plast
Surg 63:1520