Concepts in Navel Aesthetic: A Comprehensive Surface Anatomy Analysis.

[INTRODUCTION] The navel contributes to abdominal surface identity and beauty. In Western societies, the display of the navel in women's 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 xiphoid-umbilicus:umbilicus-abdominal mean crease ratio of 1.62 ± 0.16. The data dispersion for the other three ratios was wider, making them less reliable as references. The most appreciated navel shape was the vertical oval with superior hooding (82 %), and the less appreciated ones were the horizontal oval (29 %) and the protruding shape (47 %). When comparing navel position on the same body, the majority of participants choose the one with the navel relocated according to the golden ratio (i.e., 1.618) CONCLUSION: The most attractive navel position is located at the xiphoid-umbilicus:umbilicus-abdominal crease golden ratio. Bony landmarks seem to be not reliable as references for proper navel positioning. The use of the Fibonacci (golden mean) caliper intraoperatively might aid in proper positioning of the navel in abdominoplasty.