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A Measurement System and Ideal Breast Shape

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Evidence-Based Cosmetic Breast Surgery

Abstract

Evaluation of changes in breast shape, including upper pole fullness, breast projection, and bottoming out, has been limited by a lack of an accepted definition of these entities and no standardized system for measurements. One-dimensional methods (e.g., tape measurements) are too simple and three-dimensional imaging is too complicated for general use. The nipple is not a suitable marker for measuring glandular ptosis because its position may not align with the level of the breast gland.

A practical two-dimensional measurement system provides plastic surgeons with a means to measure their results. This system is based on a horizontal plane drawn at the level of maximum postoperative breast projection. Standardized before-and-after frontal and lateral photographs are compared. Breast projection, upper pole projection, lower pole level, nipple level, lower pole width, breast area, and areola diameter are measured. The breast parenchymal ratio, convexity, breast mound elevation, lower pole ratio, and nipple displacement may be calculated from these simple measurements.

Patients prefer convexity and a breast shape that is fuller on the top than on the bottom. The nipple should be located at the level of maximum breast projection. Areola diameters <5 cm are preferred. A semicircular lower pole contour is ideal. Lower pole ratios (lower pole width/lower pole length) greater than 2 appear boxy. Such ratios are typically produced by Wise pattern mammaplasties, which trade projection for width. In a ptotic or hypertrophic breast, the breast takes on an elliptical shape. Ideally this shape is reduced to a semicircle after an effective mastopexy. The three-dimensional shape of the ideal lower pole is a sphere that is flattened in the anteroposterior dimension, called an oblate spheroid, which is also the shape of a round (non-form-stable) saline or silicone gel breast implant.

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  1. Swanson Center, Leawood, KS, USA

    Eric Swanson MD

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  1. Eric Swanson MD
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Swanson, E. (2017). A Measurement System and Ideal Breast Shape. In: Evidence-Based Cosmetic Breast Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-53958-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-53958-4_2

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