As more and more women wear belly shirts, low-rise jeans, and other fashions that bare the navel, the previously overlooked belly button is the new hot item on the growing list of body features that women obsess about. As more people engage in navel-gazing, those who don’t like what they see are increasingly going under the knife to convert their undesirable “outie” belly buttons to the fashionably-acceptable “innie”.

Called an umbilicoplasty, or belly-button surgery, this procedure has been occasionally performed for medical reasons, such as a hernia. But in recent years, most umbilicoplasties have been done mostly for cosmetic reasons. Outies are “out,” innies are “in.” Many women have the procedure done following pregnancy, which may cause those who once had innies to develop outies.

According to the American Society of Aesthetic Plastic Surgery, over 8,000 umbilicoplasty surgeries were performed between 2002 and 2005. But these numbers only tell part of the story, as surgeons are performing hundreds more belly button surgeries in combination with tummy tucks. With a range of age groups undergoing the procedure, it has become evident that the desire to turn outies to innies transcends both generations and fashion trends. More than a fad, the innie belly button aesthetic appears to be on its way to becoming a social beauty standard.

The umbilicus or “belly button” is a scar that heals after the umbilical cord detaches from the body following birth. Its shape is determined by the attachment of one’s skin to the underlying muscle. Doctors say that the way in which this scar forms or attaches to the muscle is arbitrary. Dr. Michael Bermant, a plastic surgeon, explains that innie scars “curve into the deepest component of that area” and outie scars heal with “an extra bubble of tissue.” The shape of the belly button is also influenced by the tightness of one’s skin, the amount of fat under the skin, or occurrences such as umbilical hernias.

Typically, umbilicoplasty may be performed in an outpatient setting under local anesthesia, normally lasting about one hour. The surgery usually takes place in a doctor’s office operating room, but a surgical facility may be used if the umbilicoplasty is combined with other plastic surgical procedures, such as a tummy tuck. In his article, “Umbilicoplasty: conversion of ‘outie’ to ‘innie’,” plastic surgeon Dr. Darryl Hodgkinson explains the process of an umbilicoplasty. First, the umbilical scar, or “outie” belly button is cut. Then, using 2 skin flaps, one to line the reconstructed tube and the other to form the superior hood, or top bit of overhanging skin, the “innie” is formed using sutures. The procedure involves a minimal amount of pain, if any. Possible risks include scarring, infections, or the need for further surgeries. Patients may return home immediately after the surgery, and many resume normal daily activities within days. Swelling and bruising are typical immediately following the surgery. Incisions are hidden within the belly button and sutures are either dissolvable or removed in 7 to 10 days. According to data compiled by the American Society of Aesthetic Plastic Surgery, the average cost of an umbilicoplasty is $1,688. However, this price varies from city to city and does not include the cost of anesthetics or the surgical facility. With these additional costs, the price frequently ranges from $2,000 to $4,000.

Clive Thompson for the New York Times Magazine wrote in December of 2002, “Consider what’s going on here: a style of clothing is driving a style of surgery. But with umbilicoplasty, the body has become as plastic as fashion — to be nipped and tucked along with trends that themselves might last only a matter of months.” However, it is clear that this procedure is not the result of a fleeting trend, as Thompson suggested. Five years after his article, umbilicoplasties are as popular as ever.

In this area of physical appearance, most people seem to share the same sentiment, regarding innies as more attractive than outies overall. Researchers from the division of plastic surgery at the University of Missouri, Columbia, published an article entitled, “In search of the ideal female umbilicus,” which supports this notion. The article discussed what researchers found to be the preferred appearance for the umbilicus, or belly button. 147 females, between the ages of 18 and 62 years, had their belly buttons photographed. These pictures were then scored by a panel, rating their level of attractiveness. The T- or vertically shaped belly button scored the highest, while larger belly buttons, those with any amount of protrusion, horizontal orientation, or distorted shape scored lower. The “T” shape they mention is created by a tiny bit of skin overhanging the top part of the belly button. These findings, which support the idea that people typically find innies to be more attractive than outies, may help to explain why so many people are undergoing this procedure.

Although patients may have differing reasons or motives for getting an umbilicoplasty, it most often has to do with their wanting to feel more attractive or confident when displaying their bare midriff. The ABC news article, “Some Seek Surgical Solution for ‘Outies,’ Eyebrows: Cosmetic Procedures on the Rise to Perfect Unlikely Body Parts,” details the story of one such woman. Alyssa Jaronko, a fitness instructor and mother of three said, “After I had children, my belly button definitely did not look how it used to. All the exercise I could do in the world was not going to fix this skin.” Dr. Michael Rose, a plastic and reconstructive surgeon, agreed with Jaronko. He explains, “From having the children inside of her abdomen, they caused hernias to happen, one actually inside the belly button which pushed the belly button out and gave her an outie,” he said. After her umbilicoplasty, Jaronko is now more confident, and is excited to be able to once again wear bikinis and have the stomach she did before having children. Dr. Rose says, “Springtime is always when we see a huge spike in cosmetic procedures that affect the body. People are thinking about the beach and how they’re going to look.”

Whether it be for their eyes only, for a significant other, or for the eyes of the public at the beach, people can feel more confident in their appearance when baring their stomachs thanks to this plastic surgery procedure.

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