The belly button, or umbilicus, is a familiar feature on the human abdomen, but it is not an organ; it is simply a scar. This scar forms where the umbilical cord once connected a developing fetus to the placenta, acting as the lifeline for nutrient and oxygen exchange. While nearly everyone possesses this remnant, it is indeed possible not to have a belly button. The absence of the navel can result from extremely rare congenital developmental anomalies or from later surgical procedures performed for medical or reconstructive reasons.
The Standard Formation of the Navel
The umbilical cord serves as the conduit to the placenta, delivering oxygenated blood and nutrients to the fetus and removing waste products. This structure contains two arteries and one vein, all encased in a protective layer called Wharton’s jelly. The cord connects directly to the fetus at the point that will eventually become the navel.
After birth, the umbilical cord is clamped and cut, leaving a small stump attached to the infant’s abdomen. This tissue dries out, typically shrinking and falling off within one to three weeks. The resulting indentation in the skin is the umbilicus, a lifelong scar marking the natural closure of the body wall at the site of the cord’s attachment. The final appearance of the navel, whether an “innie” or an “outie,” depends entirely on how the underlying skin and scar tissue heal.
Congenital Conditions Leading to Absence
The absence of a navel from birth is a rare occurrence known as umbilical agenesis, usually associated with severe developmental anomalies. Conditions like omphalocele and gastroschisis are abdominal wall defects where the intestines or other organs protrude outside the body. Omphalocele is a defect where abdominal organs are contained within a thin sac outside the body wall.
Surgical intervention to repair these defects immediately after birth is required to place the organs back into the abdomen and close the body wall. The extensive repair and skin grafting needed often involves smoothing the skin across the area where the navel would normally be. This corrective process results in a flat or slightly indented scar rather than the characteristic recessed appearance of a typical belly button.
Other complex congenital conditions, such as bladder exstrophy or cloacal exstrophy, also involve significant defects in the lower abdominal wall. These conditions require extensive reconstruction of the abdominal tissues and musculature. The complex repair of the body wall often necessitates the sacrifice of the original umbilical insertion site, leading to a smooth abdominal contour without a navel.
Surgical Reasons for Removal or Alteration
A person can lose their natural belly button later in life due to planned surgical procedures. The most common reason is an abdominoplasty, or “tummy tuck,” which is a cosmetic surgery designed to remove excess skin and tighten the abdominal muscles. During a full abdominoplasty, a large section of skin is removed, and the remaining skin is pulled down and taut.
The original navel is often preserved on its stalk but detached from the surrounding skin, and a new opening is created in the repositioned skin flap to bring the navel back through. If the patient has a significant amount of excess skin or a history of severe scarring, the surgeon may choose to remove the original navel entirely and create a smooth closure. This results in a completely smooth abdomen, or sometimes a small, indistinct scar where the navel used to be.
A navel may also be intentionally removed in a procedure called an umbilectomy, which may be done electively as a form of body modification. Medically, the navel may be removed as part of reconstructive surgery following the removal of tumors, significant trauma, or to repair a large, complicated umbilical hernia.