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Definitions of Abnormal Breast Size and Asymmetry: A Cohort Study of 400 Women

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  • Breast Surgery
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Abstract

Background

Macromastia, micromastia and breast asymmetry have an impact on health and quality of life. However, there is scarce information addressing breast size and asymmetry frequency distribution in reference populations.

Objective

The current study aims to identify factors that influence breast size and symmetry and classifies abnormal breast sizes and breast asymmetries in an adult German population.

Methods

Breast base dimensions, breast volume, symmetry, and other breast anthropometric parameters of 400 German female patients were determined in a retrospective review of the MRI archives at our institution. Professional medical MRI-segmentation software was used for volume measurement.

Results

A total of 400 Patients were retrospectively enrolled. The patients had a mean age of 50 ± 12 years (min: 24; max: 82), mean BMI of 25.0 ± 5.0 (min: 14.7, max: 45.6), and a mean total breast volume of 976 ml (right: 973 ml, min: 64, max: 4777; left: 979 ml, min: 55, max: 4670). The strongest correlation of breast volume was observed with BMI (r = 0.834, p < 0.001), followed by breast base width (r = 0.799, p < 0.001). Smaller breasts have higher breast volume asymmetry ratios (r = − 0.124, p < 0.014). For a BMI between 18.5 and 24.9 kg/m2, micromastia is defined by breast volumes below 250 ml (5th percentile) and macromastia by volumes above 1250 ml (95th percentile). Abnormal breast volume asymmetry (< 5th and > 95th percentile) is equivalent to an absolute difference of approximately 25% relative to the smallest side (bidirectional asymmetry ratio 5th percentile − 19%; 95th percentile 26%).

Conclusion

This study provides normative data of German women, as well as selected size-for-BMI percentiles and asymmetry ratio percentiles. The normative data may help to establish transparent and objective coverage criteria for health insurances.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Funding

This research received no external funding

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Authors and Affiliations

  1. CenterPlast Private Practice, Bahnhofstr. 36, 66111, Saarbrücken, Germany

    Stéphane Stahl & Adelana Santos Stahl

  2. Department of Women’s Health, University Hospital Tübingen, Calwerstr 7/6, 72076, Tübingen, Germany

    Dominik Dannehl

  3. Department of Plastic Hand and Reconstructive Surgery, BG Trauma Center Tübingen, Schnarrenbergstr 95, 72076, Tübingen, Germany

    Adrien Daigeler

  4. Department of General-, Visceral-, Vascular-, and Pediatric Surgery, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg, Saar, Germany

    Cristina Jorge

  5. Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    Andreas Brendlin, Florian Hagen & Konstantin Nikolaou

  6. Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany

    You-Shan Feng

  7. Department of Diagnostic and Interventional Neuroradiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    Arne Estler

Authors
  1. Stéphane Stahl
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  2. Dominik Dannehl
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  7. Adelana Santos Stahl
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  10. Arne Estler
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Corresponding author

Correspondence to Arne Estler.

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Ethics Committee of the University of Tuebingen, Project No. 16/2022 BO2

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Stahl, S., Dannehl, D., Daigeler, A. et al. Definitions of Abnormal Breast Size and Asymmetry: A Cohort Study of 400 Women. Aesth Plast Surg 47, 2242–2252 (2023). https://doi.org/10.1007/s00266-023-03400-4

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  • DOI: https://doi.org/10.1007/s00266-023-03400-4

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