Ideal Male Umbilicus: An Observational Study of Surface Anatomy and Introduction to the SHAPE Classification

Abstract

Background: The umbilicus is crucial to the aesthetic appearance of the abdomen. With abdominoplasty and umbilicoplasty, placement of the umbilicus is essential and often left at the surgeon’s discretion. This study aims to investigate the ideal male umbilical shape and location by examining photographs of top male models in 2019. Methods: In this observational study, we examined 81 photographs of top male models to assess different ratios based on anatomical landmarks and umbilical appearance. Results: The ratio of the distance from the xiphoid to the center of umbilicus (XU) and corresponding distance from center of umbilicus to abdominal crease (UC) had the most reliability (ratio XU/UC, with average measurement: 1.68 ± 0.38), which placed the male navel at a similar position but marginally below the average female umbilicus. Our findings revealed that an oval horizontal is the ideal umbilical shape in males, which differs from what is most aesthetically pleasing in females (oval vertical). In addition, we introduced the SHAPE (Shape, Hood, Adiposity, Protrusion & Position, External piercing) classification for navel appearance to better define the umbilicus and its direct management. Conclusions: This study establishes that the ideal male umbilicus differs from that of females; it should be placed at the XU/UC ratio of 1.68 ± 0.38 and aim for a horizontal shape with hooding (SHAPE: H II). The SHAPE classification facilitates a logical stepwise approach for the surgeon to refashion the umbilicus. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.