ORIGINAL ARTICLE AESTHETIC

Concepts in Navel Aesthetic: A Comprehensive Surface AnatomyAnalysis

Giuseppe Visconti Emiliano Visconti

Lorenzo Bonomo Marzia Salgarello

Received: 17 September 2014 / Accepted: 18 November 2014

Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2014

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 pic-

tures, 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 accept-

able narrow data spread of the xiphoidumbilicus:umbili-

cus-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 xiphoidumbilicus: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.

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Keywords Umbilicus Omphaloplasty Abdominoplasty Lipoabdominoplasty Umbilicoplasty Divine proportion Golden ratio

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

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. SalgarelloDepartment 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. BonomoDepartment of Bioimages and Radiological Sciences, Universita`

Cattolica del Sacro Cuore University Hospital A.

Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy

123

Aesth Plast Surg

DOI 10.1007/s00266-014-0434-z

1.5 and 2 cm in diameter. Its appearance is influenced by

age, weight, pregnancies, and hernias. The umbilicus

contributes to abdominal surface identity and beauty. Since

the dawn of time, it has been considered an erogenous zone

across the world. Since the introduction of the bikini in

1946, as well as low-rise clothing and crop tops in the

1990s, the display of the navel in womens fashion has

grown in Western societies, with navel piercing and tattoos

becoming more common. The higher attention toward the

navel shape and position paid by women asks for a more

critical analysis by the plastic surgery community of this

peculiar skin structure.

Besides the fact that the concept of ideal navel may vary

among people and may be influenced by age, ethnicity, and

personal preference, few studies are available on navel

surface anatomy and there is no standardization regarding

its proper placement when performing omphaloplasty in

cosmetic abdominoplasty. The information available on

proper navel positioning is usually based on surgeons

experience or on analysis of ethnic groups of people

selected by researchers.

The aim of this study is to analyze the navel position and

shape of the worldwide top model/celebrities recognized as

top 2013 bikini models to determine references for ideal

navel shape and positioning and to find potential clinical

translation.

Materials and Methods

This observational study comprised three parts:

(A) Quantitative study of the navel surface anatomy in 81

top 2013 bikini models by analyzing four propor-

tions: xiphoid-center of umbilicus/center of umbili-

cus-abdominal crease (XU:UC) ratio; inter-anterior

superior iliac spine line (interASIS)/center of umbi-

licus-abdominal crease (UC) (InterASIS:UC) ratio;

interASIS/center of umbilicus-interASIS (interA-

SIS:interASIS-U) ratio; center of umbilicus-interA-

SIS/inter iliac crest line (interIC)-center of umbilicus

(interASIS-U:interIC-U) ratio (Fig. 1).

Fig. 1 Artwork depicting abdominal frame and lower trunk aestheticunits in frontal view. The pelvis bony framework influences the shape

of the abdomen and gives surface bony landmarks that are usually

used for umbilicus position analysis such as the apex of the iliac

creasts, the anteriorsuperior iliac spine and the pubic symphysis. The

yellow line (inter apex of the iliac crest distance (interIC)), red line

(inter-anterior superior iliac spines distance (interASIS)), the red

dotted line (interASIS-center of umbilicus), and the yellow dotted line

(interIC-center of umbilicus distance) represent the bony framework

parameters analyzed in this study. The lower trunk aesthetic units in

frontal view are the flank (orange), upper abdomen (light pink

area upward the umbilicus), umbilicus, lower abdomen (pink

area downward the umbilicus), and mons pubis (violet). The black

dotted line identifies the abdominal crease, a watershed crease

extending from one ASIS to the other and separating two fleshy

prominences, the lower abdomen and the mons pubis. The blue

line (xiphoid-center of umbilicus distance (XU)) and the white line

(center of umbilicus-abdominal crease distance (UC)) represent the

parameters analyzed according to the abdominal aesthetic units.

These parameters were used to calculate the four proportions: XU:UC

ratio, interASIS:UC ratio, interASIS:interASIS-U ratio, and interIC-

U:U-interASIS ratio

Aesth Plast Surg

123

(B) Analysis of navel shapes in 81 top 2013 bikini

models was recorded and classified based on previous

study of Craig SB et al. The vertical to horizontal

umbilical (V:H) ratio has been calculated for each

navel (Fig. 2).

(C) On-line survey via facebook.com made of seven

multiple-choice questions, involving 1,682 invited

people unaware of our concepts in navel aesthetic

(Figs. 3, 4). Of these, 102 participants (67 women

and 35 men) effectively took part in the survey.

Part AAnalysis of the Navel Surface Anatomy in 81

Top 2013 Natural Bikini Models

Photographs of celebrities and top models were taken from

six open on-line gossip magazines (celebuzz.com, stylebi-

stro.com, gossipcenter.com, perezhilton.com, huffington-

post.com, and theholliwoodgossip.com) providing the list

of top bikini 2013. These are recognized among the

worldwide top 15 on-line gossip magazines. Moreover,

bikini pictures of nine current Victorias Secret Angels

have been analyzed as well.

Only front pictures of the entire body in a natural

orthostatic position with good light exposure were con-

sidered for analysis. Pictures with both arms elevated, with

unnatural poses, with trikini or other swim wear obscuring

the xiphoid, umbilicus, iliac crest, ASIS, and abdominal

crease, as well as celebrities/models who underwent

abdominoplasty, were excluded. Being not standardized as

clinical photographs would be, we took care to consider

only high-definition pictures to make the analysis as stan-

dardized as possible. As a result, 81 top bikini bodies of

2013 were included in this study. The mean celebrity/

model age was 35.1 (ranging from 22 to 58 years old). The

Fig. 2 Navel shapes found inthe analysis of 81 top bikini

models have been classified

according to Craig et al. and

submitted for a facebook.com

survey. a vertical lozengewithout superior hooding,

b oval vertical with superiorhooding, c round withsuperior hooding, d t-shapedwith superior hooding, e ovalhorizontal with superior

hooding, f protruded/outienavel with superior hooding

Fig. 3 Pictures submitted for a facebook.com survey from which theparticipants had to choose the navel position that looks the most

harmonious, natural looking, and aesthetically pleasant. Which one do

you prefer, a or b? a XU:UC ratio 1.618 (edited). b XU:UC ratio1.4913 (original)

Fig. 4 Pictures submitted for the facebook.com survey from whichparticipants had to choose the navel position that looks the most

harmonious, natural looking, and aesthetically pleasant. Which one do

you prefer, a or b? a XU:UC ratio 1.618 (edited). b XU:UC ratio1.5206 (original)

Aesth Plast Surg

123

mean celebrity/model height was 169.4 cm (ranging from

155 to 177 cm).

A picture analysis of proportions described in Part A

(see also Figs. 1, 2) was performed using the ruler tool in

Adobe Photoshop CS7 (Abode Systems, San Jose, CA,

USA) and the proportions were evaluated by pixel

measurement.

Statistical analysis of the collected data was made to

obtain mean values with standard deviations. The sum-

marized results are provided in Fig. 5.

Part BAnalysis of Navel Shapes in 81 Natural Top

Bikini Models of 2013

The pictures included in this study (see Part A) have been

zoomed in at the level of the navel to classify the navel

shape based on a previous study of Craig et al. and to

obtain a V:H umbilical ratio. Proportions have been cal-

culated using the ruler tool in Adobe Photoshop CS7.

Statistical analysis of the collected data was made to obtain

mean values with standard deviations. The mean V:H

umbilical ratio was 1.3 0.46 (minimum value 0.41,

maximum value 2.57).

Part COn-Line Survey

After considering the result of the statistical analysis of the

data in Part A, an on-line survey consisting of seven

multiple-choice questions was conducted via facebook.com

in English and Italian languages. In two questions, the

participants had to choose the most harmonious, natural-

looking, and aesthetically pleasant navel and the less

harmonious, not natural-looking, and not aesthetically

pleasant navel among the 6 different navel shapes found

in Part A analysis. The navel pictures were obtained by

zooming in on the highest-definition pictures taken in Part

A (Fig. 2).

In each of the other 5 questions, we provided two

photographs of the same celebrity/model of which one was

the original photograph and the other one had the umbilicus

position relocated according to the ideal XU:UC ratio of

1.618. This editing was performed using the patch tool in

Adobe Photoshop CS7. The participant had to choose in

which of the two pictures the navel position looks more

harmonious, natural looking and aesthetically pleasant.

As the XU:UC ratio range found in Part A was from 1.11 to

2.31 (mean 1.62), the five pictures submitted to the on-line

Fig. 5 Dispersion graph of the proportion values found in eachpicture analyzed. Xiphoid-center of umbilicus: center of umbilicus-

abdominal crease (XU:UC) ratio (mean 1.62 0.12, ranging from

2.31 to 1.11); inter-anterior superior iliac spine distance: center of

umbilicus-abdominal crease (interASIS:UC) ratio (mean 2.04 0.35,

ranging from 1.58 to 2.73); inter-anterior superior iliac spine-center of

umbilicus : inter-anterior superior iliac spine (interASIS-U:interASIS)

ratio (mean 3.07 0.74, ranging from 1.79 to 5.22); inter iliac crest

apex-center of umbilicus : inter-anterior superior iliac spine (interIC-

U:U-interASIS) ratio (mean 2.87 1.92, ranging from 0.86 to 11.83)

Aesth Plast Surg

123

survey were chosen based on the following XU:UC ratios,

1.111.4, 1.41.5, 1.51.59, 1.651.8, and over 1.8, to

better represent the entire sample. For each of these ratio

categories, the most appropriate pictures for editing were

selected and edited. (Figures 3, 4)

The aim of this survey was to investigate the impact of

our findings on spontaneous human perception of navel

position harmony and beauty.

Results

Part AAnalysis of Navel Surface Anatomy in 81

Natural Top Bikini Models in 2013

Statistical analysis results (mean SD) of the four pro-

portions measured in Part A are shown in Table 1.

The analysis revealed that navel position is quite vari-

able 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 devi-

ation 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 interASIS-

U: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

et al. (Fig. 2). Five (6.2 %) navels were classified as

vertical lozenge without superior hooding (Shape a), 29

(36 %) umbilici were classified as oval vertical with

superior hooding (Shape b), 23 (28.4 %) round with

superior hooding, 18 (22 %) t-shaped with superior

hooding, 5 (6.2 %) oval horizontal with superior hoo-

ding, and 1 (1.2 %) protruded navel with superior hoo-

ding (Fig. 2).

The data spread of the V:H ratio is quite wide to draw

strong conclusions. However, this analysis reveals that the

navel shapes tend to be more vertical than horizontal.

Part COn-Line Survey

The mean age of participants was 32 years old (ranging

from 25 to 48 years old). Of these, 85 were European, 10

were from North America, 5 were from South America,

and 2 were from Asia.

Eighty-four participants (82 %) voted that Shape b (oval

vertical with superior hooding) as the most harmonious,

natural-looking, and aesthetically pleasant navel followed

by 13 people (13 %) preferring Shape c and 5 people

voting for Shape a. The remaining shapes were not chosen

by anyone.

Fifty participants (47 %) voted Shape f (protruded

navel) as the less harmonious, not natural-looking and not

aesthetically pleasant navel, followed by 29 people

(29 %) who disliked Shape e and 10 people (10 %) dis-

liking Shape d. The remaining 13 participants (14 %) voted

Shapes b and c (6 % each) and, lastly, shape a (2 %)

(Fig. 2).

In all five questions, each including two pictures com-

paring navel position on the same body, the majority of

participants preferred the picture with the navel relocated

according to the golden ratio of 1.618, with variable

percentages.

Discussion

Since the first historically relevant report by Vernon in

1957 [1], almost every author reporting his/her abdomi-

noplasty technique has usually provided a personal om-

phaloplasty 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 mid-

line, 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

Table 1 Table showing results (mean standard deviation, mini-mum and maximum values) of the four proportions analyzed (navel

position) and of the vertical to horizontal navel ratio

Ratio Mean standard

deviation

Min and max

values

XU:UC 1.62 0.12 Min 2.31max 1.11

interASIS:UC 2.04 0.35 Min 1.58max 2.73

interASIS:interASIS-U 3.07 0.74 Min 1.79max 5.22

interASIS-U:interIC-U 2.87 1.92 Min 0.86max 11.83

vertical to horizontal

navel

1.30 0.46 Min 0.41max 2.57

XU:UC xiphoid-center of umbilicus:center of umbilicus-abdominal

crease ratio, interASIS:UC inter-anterior superior iliac spine

line:center of umbilicus-abdominal crease ratio, interASIS:interASIS-

U interASIS : center of umbilicus-interASIS ratio, interASIS-U:in-

terIC-U interASIS-center of umbilicus : inter iliac crest line -center of

umbilicus ratio)

Aesth Plast Surg

123

bony landmarks (i.e., fixed distanced from the waistline or

from the anterior iliac crest) to properly relocate the navel

[1, 4, 5].

So far, there is a lack of consensus on the proper navel

position in abdominoplasty, and this matter is left to the

artistry and sense of beauty of each surgeon.

In the literature, the very few works on navel surface anat-

omy have focused on two main topics: shape and position.

Navel shape has been extensively studied by Craig et al.

[6]. They classified the navel shape of 147 women and

submitted close-up views to 21 examiners who scored each

navel. According to their analysis, the most appealing

umbilicus is small in size, with a T or vertical shape and

superior hooding. Lack of the superior hooding, distorted

and horizontal shape, as well as protrusion (outie), have

been judged as signs of an unpleasant navel. The outie

navel, however, not only represents a different navel shape

with excess skin/scar-like tissue but it may be a clinical

sign of umbilical hernia. This condition has to be taken into

account when evaluating a patient seeking abdominoplasty.

The findings from our study are in line with those of Craig

et al. regarding the features of an aesthetically pleasing

navel. However, we found the pleasant navel to be oval or

round in shape with superior hooding. The T-shaped navel

did not catch participants attention. Sakamoto et al. ana-

lyzed 254 Japanese navel shapes with ages ranging from

1 month to 16 years old, concluding that the umbilical

shape is usually more horizontal during infancy and grad-

ually changes into a length-wise and deeper shape with

growth [7]. Nevertheless, these observations may be

influenced by ethnicity, which are in line with our findings

(V:H ratio mean 1.30 0.46). Choundhary and Taams

analyzed the navel appearance in different positions, find-

ing that superior hooding is a result of gravity on the given

navel when the subject is in a standing position. In the

supine position, the superior hooding disappears. In the

upside-down position, inferior hooding appears as a

counterpart of the superior hooding seen in the standing

position [8]. This demonstrates that hooding is the bio-

mechanical result of the umbilical scar under the influence

of gravity and surrounding soft tissues.

Navel position on the abdominal wall is usually ana-

lyzed bi-dimensionally, on a transverse and median lon-

gitudinal axis. The only comprehensive analysis of navel

position on the transverse axis comes from Rohrich et al.,

who analyzed 116 female navels on the transverse body

axis, and found that the umbilicus is rarely midline. [9]

This work is considered very valuable for both clinical

analysis and for medicolegal implications. However, the

ideal umbilicus remains anatomically defined as a midline

structure of the linea alba.

On the median longitudinal axis, the anatomy books

locate the umbilicus between the third and fourth lumbar

vertebrae. However, this reference is not useful for plastic

surgeons when dealing with omphaloplasty intraopera-

tively. So far, Vernon suggested placing it around 4 cm

below the waistline, Baroudi and Pitanguy positioned it on

the projection of the umbilical stalk in a neutral position,

whereas Hinderer advised locating it 3 cm above the level

of the anterior iliac crest. [14]. Based on their study on

100 non-obese patients, Dubos and Osterhout concluded

that in 96 % of their cases, the umbilicus is located at the

topmost level of the iliac crest [5]. So far, all the authors

trying to find a method to locate the navel position on the

longitudinal axis used pelvic bony landmarks and fixed

values, and not ratios. Recently, Abhyankar et al. reported

their analysis of 75 Indian female volunteers in the supine

position, finding that the xiphisternumumbilicus distance/

umbilicuspubic symphysis distance ratio is approximately

1.6:1 and the ratio of the distance between the umbilicus

and ASIS and the interASIS distance is 0.6:1. [10] Another

ethnic study of 65 Iranian patients suggested using a

mathematical formula to properly locate the navel [11].

Nevertheless, the Indian study can be influenced by

ethnicity features and it has not been performed on

worldwide recognized beautiful abdomens. These findings

are in line with ours as we used the abdominal crease and

not the pubic symphysis (lower positioned) as the inferior-

most limit. Using the xiphisternum and the abdominal

crease as superior and inferior abdominal surface limits, the

evaluation of the abdominal aesthetic units only can be

performed. [12] Our analysis reveals that the attractive

navel is located in the golden ratio (i.e., 1.618) within the

abdominal aesthetic unit (i.e., xiphoidumbilicus to umbi-

licus-abdominal crease ratio.). The other calculated ratios

based on pelvic bony landmarks showed a wider spread of

data that makes them less reliable as references for

appropriate navel positioning. This is very likely related to

the high variability of pelvic bone angulations and

dimensions in the female population, as we already know

from framework analysis in gluteal augmentation from

Mendieta [13].

The golden ratio has been studied since ancient Greek

times as it usually appears in geometry and Nature. It

influenced the ancient arts and architecture. In the 13th

century, the Italian mathematician Leonardo Fibonacci

introduced the golden mean number sequence and studied

the golden section. For this reason, concepts and objects

related to the golden ratio are typically named Fibonacci,

such as the golden mean or Fibonacci Caliper. This com-

pass-like instrument is made of three arms. The lateral-

most arms identify the extremes of a line, whereas the

central arm divides the given line according to the golden

mean. Being compass like, it is possible to open/close the

instrument to the desired size and the central arm always

identifies the golden ratio of the given line (Fig. 6). Luca

Aesth Plast Surg

123

Pacioli and Leonardo Da Vinci introduced the concept of

the golden ratio (called divine proportion) in the analysis

of human body proportions in the famous De Divina Pro-

portione book. These findings influenced one of the most

popular paintings of Leonardo Da Vinci, the Mona Lisa.

Besides the observation that vertical body anthropometrics

usually follow the golden ratio, in plastic surgery literature,

this ratio has been usually limited to facial anthropometric

analysis and not for other parts of the body. In dentistry, the

concept of the golden proportion in teeth size and position

analysis has been introduced by Levin [14]. His concepts

and instruments (dental golden mean gage and grids) have

deeply influenced the dentistry practice worldwide. Now-

adays, the Fibonacci caliper is frequently used by artists,

designers, and architects to produce works that are aes-

thetically pleasant to human eyes.

After the results of our observational study, we have

been using the Fibonacci caliper intraoperatively since

August 2013 to precisely locate the navel in abdomino-

plasty and DIEP flap breast reconstruction (Fig. 6). At the

beginning of the procedure, the navel is isolated and

skeletonized on its pedicle in a triangular shape with the

apex pointing downward. After the superior abdominal flap

is undermined in the suprafascial plane and plication of the

rectus sheath achieved, when needed, the patient is placed

in a semi-Fowler position and the superior abdominal flap

is temporarily advanced to the inferior suprapubic incision.

At this point, the ideal new navel position is marked by

calculating the golden ratio (1.618) of the line connecting

the xiphoid to the abdominal crease (usually the infe-

rior abdominal incision) along the midline. This point

(called /) can be easily marked with the aid of the Fibo-nacci caliper. Point / identifies the center of the newumbilicus. An 18G cannula needle is then inserted through

/ perpendicularly to the abdominal flap to exactly projectit on the rectus sheath (point /), where the umbilical stalkwill be centerd with four cardinal 3-0 absorbable stitches.

Omphaloplasty is then performed by an inferior-based tri-

angular incision on the abdominal skin centerd on point /,defatting around the skin recipient and insetting of the

navel in its new position with two layers of absorbable and

fast absorbable sutures. The operation is then completed as

in standard abdominoplasty. Since the first historical report

by Vernon in 1957 [1], many omphaloplasty techniques

with different incision patterns to relocate the navel have

been described, with no consensus on the optimal one.

However, all these techniques share the same principles:

obtaining a pleasant navel shape (i.e., round or vertical

oval, innie and with superior hooding) with minimization

of scar visibility. Incorporating abdominal skin flaps within

the neo-omphaloplasty incision pattern may be advanta-

geous to interrupt the periumbilical scars to avoid cir-

cumferential scar contraction and navel stenosis [15]. We

are currently evaluating in our clinical series the resulting

navel position and the influence on the hooding observed

postoperatively using this new approach.

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 sug-

gested for proper navel positioning, as pelvic bony land-

marks 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 hoo-

ding, 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 inany of the products, devices, or drugs mentioned in this manuscript.

Fig. 6 Above, left Stainless steel hand-made Fibonacci caliper(golden mean caliper) opened and closed. Above, right 46-year-old

breast cancer patient undergoing delayed right autologous breast

reconstruction with DIEP flap after failed implant reconstruction for

nipple-sparing mastectomy and contralateral periareolar mastopexy

for symmetry. The abdomen is temporarily closed and the Fibonacci

caliper is pointed between the xiphoid and the abdominal crease to

find the ideal navel position (point /). Below, left An 18-gage needleperpendicularly placed through point / to project it on the abdominalfascia to precisely fix the navel. Below, right Navel position at the

divine proportion is confirmed with the Fibonacci caliper at the end of

surgery

Aesth Plast Surg

123

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Concepts in Navel Aesthetic: A Comprehensive Surface Anatomy AnalysisAbstractIntroductionMaterials and MethodsResultsConclusionNo Level Assigned

IntroductionMaterials and MethodsPart A---Analysis of the Navel Surface Anatomy in 81 Top 2013 Natural Bikini ModelsPart B---Analysis of Navel Shapes in 81 Natural Top Bikini Models of 2013Part C---On-Line Survey

ResultsPart A---Analysis of Navel Surface Anatomy in 81 Natural Top Bikini Models in 2013Part B---Analysis of Navel Shapes in 81 Natural Top Bikini Models in 2013Part C---On-Line Survey

DiscussionConclusionsConflict of interestReferences