Everything is backwards in Cincinatti... This sexual gesture involves the male subject to be "titty fucking" the female subject backwards. The female's view now reveals the male's rear end and right below it, his scrotum in the shape of a bow-tie, right where a bow-tie would normally rest.

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From the movie The Forty Year-Old Virgin.

This is the official definition from the director/co-writer, Judd Apatow.

You shit on someone's chest (or someone shits on yours) and you smush it all around with your ass cheeks, leaving a bow-tie shaped shit-smear

When you titty fuck someone backwards so that your balls are on their neck and it looks like a bowtie.

This is when a girl gives a guy head and he sits on top of her backwords with his ass towards her face so that when she sees his ball they look like a bow tie.

Close, but not quite. A CBT is when a man humps the tracheotomy hole in one's neck and the blood from this horrid act makes a bowtie shape when it is smeared by the man's balls.

A sex act wherein a male sits upon a woman's face so that his asshole is planted on her nose and his testicles rest firmly on her chin. The male then masturbates, climaxes and subsequently ejaculates on the woman's neck, while moving his penis from side-to-side to draw a white bow-tie.

In the American version of the Cincinatti Bow-tie, you move the penis from right-to-left. The European version is done with a left-to-right motion.