title: Intraoperative assessment of the umbilicopubic distance: a reliable anatomic landmark for transposition of the umbilicus.
abstract: BACKGROUND
  A clear understanding of the anatomic location and the aesthetic traits of the umbilicus is essential for the plastic surgeon repositioning the umbilicus during an abdominoplasty. Currently no consensus exists regarding the ideal location for this unique aesthetic unit of the abdomen. To their interest, the authors noted that the intraoperative distance from the pubic symphysis to midumbilical stalk measured 15 cm for several consecutive patients. They believe the umbilicopubic distance is another clinically useful and reliable anatomic landmark for the plastic surgeon relocating the umbilicus during an abdominoplasty.
  
  
  METHODS
  A retrospective chart review analysis was performed for 40 consecutive patients who underwent abdominoplasty or panniculectomy between July 2009 and May 2010 at the authors' institution. The intraoperative measurement of the umbilicopubic distance (pubic symphysis to midumbilical stalk) was available for 32 of these patients. The average umbilicopubic distance was calculated. Two separate graphs were generated to evaluate the relationship of the umbilicopubic distance to the patients' height and body mass index (BMI). The data were saved and analyzed using Microsoft Office Excel.
  
  
  RESULTS
  In the study population, the average intraoperative umbilicopubic distance was found to be 15.05 cm. The results validate the mean umbilicopubic distance of 15.04 cm reported by Dubou and colleagues in 1978. For patients whose stature fell between 145 and 178 cm, the umbilicopubic distance was consistently 15 cm. A tendency toward a higher umbilicus was noted as the patients became taller. The BMI did not seem to influence the location of the umbilicus as measured intraoperatively.
  
  
  CONCLUSIONS
  Translocation of the umbilicus to 15 cm from the pubic symphysis in patients with a stature of 145-178 cm is another clinically useful, safe, and expeditious method for relocation of the umbilicus during an abdominoplasty.
authors.affiliation: Division of Plastic Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, USA. rodrigj1@mail.amc.edu
authors.forename: J R
authors.initials: JR
authors.lastname: Rodriguez-Feliz
authors.forename: Sumeet
authors.initials: S
authors.lastname: Makhijani
authors.forename: Adrian
authors.initials: A
authors.lastname: Przybyla
authors.forename: David
authors.initials: D
authors.lastname: Hill
authors.forename: Jerome
authors.initials: J
authors.lastname: Chao
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D059925:Anatomic Landmarks; D000886:Anthropometry; D001837:Body Weights and Measures; D006801:Humans; D007432:Intraoperative Period; D011631:Pubic Symphysis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014472:Umbilicus / Q000601:surgery*