Title : Defining the ideal umbilicus - a structured review of aesthetic preferences in plastic surgery
Abstract:
Background/Aims: The umbilicus is a central feature of abdominal aesthetics and an important consideration in procedures such as abdominoplasty and umbilicoplasty. Despite its clinical relevance, there is no universally accepted definition of the ideal umbilicus. This review aims to identify and synthesise key anatomical and aesthetic characteristics associated with an attractive umbilicus.
Methods: A structured literature review was conducted using PubMed. Search terms included “umbilicoplasty”, “ideal umbilicus”, and “aesthetic”. Studies were included if they assessed aesthetic characteristics such as shape, size, or position. Nine studies meeting predefined inclusion criteria were analysed qualitatively.
Results: A consistent preference for an oval-shaped umbilicus was identified across multiple studies. Superior hooding was commonly associated with higher aesthetic ratings. Gender differences were noted, with vertical orientation favoured in females and horizontal orientation more frequently observed in males. Smaller umbilici were consistently rated as more attractive, typically measuring less than 1.5 to 2 cm in width. In terms of position, the ratio between the xiphoid process to umbilicus and umbilicus to lower abdominal crease was most commonly reported between 1.5 to 2 to 1. Variability in study design and measurement techniques limited direct comparison.
Conclusion: Current literature suggests that an ideal umbilicus is small, oval, and often demonstrates superior hooding, with a positional ratio of approximately 1.5 to 2 to 1. Variation exists across gender and ethnicity. A simplified aesthetic framework is proposed to support surgical planning. Further research using standardised methodologies is required to establish consensus.
