London - When Katie Holmes paraded her enviably flat stomach on the beach in Miami, eagle-eyed observers noticed that, while perfectly proportioned in almost all respects, the actress seemed to be flaunting a rather unconventional belly button.
Could it be that Mrs Tom Cruise has - horror of horrors - the dreaded outie?
I was born an outie but, at the age of five - for medical reasons - had an operation to make me an innie.
I’d never thought much about it since, but seeing Katie made me wonder: just what is it that decides whether you’re an innie or an outie? And what really does constitute the perfect belly button?
“Your belly button, or umbilicus, is essentially scar tissue,” explains Dr David Cremonesini, consultant paediatrician at the London Medical clinic. “After a baby is born, the umbilical cord is clamped and cut a few centimetres from the abdomen. Over the next week, the remaining cord dries up and falls off, leaving the belly button.”
It’s often thought that an outie is the result of pressure being exerted on the cord during birth, but it’s actually down to a medical condition which affects around one in ten newborns, known as an umbilical hernia.
The umbilical cord is designed to pass through a small opening in the baby’s abdominal muscles. This opening often closes before birth but, if the muscles don’t grow together, the resulting weakness in the abdominal wall can cause a bulge, or hernia, resulting in a protruding belly button.
According to Dr Cremonesini, most umbilical hernias will repair themselves as muscles strengthen.
So, even if you’re born an outie, you’re more than likely to be an innie by the time you hit your teens and want to start wearing midriff-baring tops. “Very few adults have outies, purely because if the hernia is not resolved by the age of around three or four, it’s usually operated on.
“It’s a relatively simple operation, usually done under general anaesthetic, in which the surgeon makes a small incision around the belly button, puts any bulging tissue in place, and stitches together the weakened abdominal muscle.”
Occasionally, in adults, the muscle wall can be weakened, leading to an umbilical hernia and causing an innie to become an outie. Factors that make this more likely include being overweight or lifting heavy objects. A simple operation can usually repair the hernia.
During pregnancy, some women may find that their belly button pops out. This is because the muscle walls of the abdomen are under a lot of pressure, but after the birth, it often returns to its innie position.
“Pregnancy is a unique condition that stretches the muscles of the abdomen, affecting the umbilicus,” says consultant plastic surgeon and President of the British Association of Aesthetic Plastic Surgeons (BAAPS), Mr Fazel Fatah.
“Conversely, when you put on weight, although some fat will be stored in the abdomen, most of it is subcutaneous, stored under the skin, and so stretches the skin, but not the muscle. As a result, the umbilicus won’t pop out.”
So, if you’re an outie, but want to be an innie, is there anything you can do? Unsurprisingly, plastic surgeons have developed techniques to create more aesthetically pleasing navels for those who want them. However, “umbilicoplasties” as they are known, remain rare in the UK and are more likely to be carried out in conjunction with a tummy tuck.
Bonnie Murphy, from Dartford in Kent, was just 14 when she had an umbilicoplasty.
“Bonnie had always had an outie but it never caused her any medical problems,” explains her mother, Jean. “It became more prominent as she got older and I became aware that it bothered her, so surgery seemed a sensible solution.”
She adds: “I don’t consider what she had done to be plastic surgery - I wouldn’t let her have a nose job or anything - but she felt it was a disfigurement and it upset her.”
Says Bonnie: “I’d been quite self-conscious about my belly button from about the age of six when someone commented that it looked unusual. So I never wore bikinis, only ever swimming costumes. I had the operation last month and I’m really glad I had it done.”
Bonnie’s surgeon, John Pereira, of the McIndoe Surgical Centre in West Sussex, admits it’s still an unusual operation in this country.
“During your career, you might only do ten or 20 procedures of this kind, usually on young children who either have a hernia that hasn’t repaired, or whose cord has been left too long and has given them a sort of floppy skin tag, which was the case with Bonnie.”
With this in mind, a group of plastic surgeons at the Countess of Chester NHS Foundation Trust decided to investigate what constitutes the perfect belly button.
“The range of what’s considered normal is very broad and so, when you’re reconstructing a belly button, it’s not always easy to decide what it should look like,” says Mr Ali Juma, one of the consultants involved in the research.
But the study did find that while women of black and Asian descent were more likely to prefer a round innie, Caucasian women showed a preference for a vertical oval belly button. “We’re not sure about the reasons for this,” says Mr Juma.
But, Katie, if you’re reading, look away now. “Nobody,” Mr Juma adds, “expressed a preference for an outie.”
On the bright side, though, at least Miss Holmes never will never get fluff stuck in it. - Daily Mail