Anthropometry of the breast region: how to measure?

JPEG and raw image files compared to direct measurement of the breast region

Purpose:

To compare JPEG and RAW image file extensions to direct measurement of the breast region.

Methods:

Points were marked on the breasts and arms of 40 female volunteers. The joining of these points in each hemibody formed seven linear segments, one angular segment and one median segment common to both hemibodies. Volunteers were photographed in a standardized fashion and evaluated by three raters using the software Adobe Photoshop CS6^® and three image file extensions (RAW, high resolution JPEG and low resolution JPEG); values were compared to direct anthropometry.

Results:

All variables had interclass correlation coefficient higher than 0.8 (ICC>0.8). On average, all variables in all methods showed differences (p<0.05) when compared to direct measurement. A formula was created for each segment and each image file extension in comparison with the direct measurement.

Conclusion:

Measurements were similar among the correlated JPEG and RAW image file extensions but differed from the actual breast measurement obtained with a caliper.

Thorax anthropometric position index: a simple evaluation of the inframammary fold position in the thorax

Appropriate positioning of the inframammary fold (IMF) is essential for breast reconstruction. The purpose of this study was to quantitatively measure and evaluate the anthropometric position of the IMF in the thorax. A total of 145 Japanese women with unilateral breast cancer were analyzed. To indicate the superior-inferior position of the IMF on the non-diseased side, the distances from the sternal notch (SN) to the IMF along the midline (SN-IMFM) and from the SN to the umbilicus (UB) (SN-UB) were measured. A new index, the thorax anthropometric position (TAP) index for the IMF, was then defined as the ratio of SN-IMFM to SN-UB. The TAP index was calculated for each patient, and its correlations with demographic parameters, including age, body height, and body mass index, were statistically assessed. The TAP index was normally distributed and ranged from 0.500 to 0.704, with a mean of 0.590. Multivariate analysis revealed that age was an independent factor associated with a higher TAP index (p < .01). In addition, the paired t-test showed that the TAP index was significantly greater in the standing position than in the supine position (p < .001). The position of the IMF in the thorax could be objectively described by the TAP index, and it was suggested to become inferior with age and the standing position. The index, along with these findings, will provide useful information for the evaluation of the breast contour in an objective and simple manner.

Anthropometric Breast Measurement: Analysis of the Average Breast in Young Nulliparous Saudi Female Population

Anthropometric measurements and proportions of the female body play a significant role in plastic and reconstructive surgery. This study is aimed to identify the descriptive measurements of the breast in a sample population of young nulliparous Saudi women.

Quantifying Dynamic Deformity After Dual Plane Breast Augmentation

BACKGROUND

Dynamic breast deformity (DBD) is characterized by visible distortion and deformity of the breast due to contraction of the pectoralis major muscle after submuscular breast augmentation; fortunately, in most cases, this is not a clinically significant complaint from patients. The purpose of this study is to present a simple method for objectively measuring DBD in patients submitted to dual plane breast augmentation (DPBA).

METHODS

We studied 32 women, between 18 and 50 years old, who underwent primary DPBA with at least 1 year of follow-up. Anthropometric landmarks of the breast were marked, creating linear segments. Standardized photographs were obtained both during no pectoralis contraction (NPC) and during maximum pectoralis muscle contraction (MPC); measurements of the linear segments were taken through ImageJ imaging software, and both groups were compared.

RESULTS

We found statistically significant differences in all analyzed segments when comparing measurements of the breasts during NPC and MPC (p < 0.001).

CONCLUSION

Our study proposes a novel, standardized method for measuring DBD after DPBA. This technique is reproducible, allowing for objective quantification of the deformity in any patient, which can be valuable for both patients and surgeons, as it allows for a more thorough discussion on DBD, both pre- and postoperatively, and may help both patients and surgeons to make more informed decisions regarding potential animation deformities after breast augmentation.

LEVEL OF EVIDENCE V

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 .

Asymmetry of Inframammary Folds in Patients Undergoing Augmentation Mammaplasty

BACKGROUND

Variation in the anatomical position of the inframammary fold (IMF) in women remains poorly studied.

OBJECTIVES

The purpose of this study was to evaluate the incidence of asymmetry between IMF locations on the chest wall of women undergoing breast augmentation and to determine breast measurements associated with IMF asymmetry.

METHODS

Three-dimensional imaging analysis of the breasts was performed in 111 women with micromastia, using the Vectra Imaging System(TM). The following measurements were recorded: vertical distance between right and left IMF (inter-fold distance), vertical distance between nipples (inter-nipple distance), and difference between projection of right and left breasts in anterior-posterior direction.

RESULTS

Asymmetry between the right and left IMF positions was found in the majority of patients (95.4%), with symmetry only found in 5 patients (4.6%). In the majority of patients (60.3%), the right IMF was located inferior to the left IMF with median inter-fold distance 0.4 cm (range, 0.1, 2.1 cm). In 39 patients (35.1%), the left IMF was located inferior to the right with median inter-fold distance 0.4 cm (range, 0.1, 1.7 cm). There was strong correlation between the degree of asymmetry of IMF and asymmetry of nipple areola complex (NAC) positions (r = 0.687, P < .01).

CONCLUSIONS

The majority of women with micromastia demonstrate asymmetry of the IMF, which correlates with asymmetry of NAC location. The authors propose a classification system based on most commonly observed IMF locations as types I (right IMF inferior to left), type II (left IMF inferior to right) and type III (both IMF located on the same level). LEVEL OF EVIDENCE 4: Diagnostic.

Photographs for anthropometric measurements of the breast region. Are there limitations?

PURPOSE

To determine the limitations of the photographs used to obtain the anthropometric measurements of the breast region.

METHODS

Five women, between the ages of 18 to 60 years, were evaluated. Photographs of the frontal and left and right profile views of their breasts were taken. Based on the current literature, the most commonly used anthropometric and anatomic landmarks for breast measurement were marked in their different positions. The different points were used to evaluate if the direct anthropometry was possible in a standardized way and determine how the points and the positions can to be used in any breast measurements.

RESULTS

There were some limitations to the use of defining points of the breast fold, as well as of its lower portion and lateral extension positions in both profiles.

CONCLUSION

The defining points of the breast fold and the profile photographs have some limitations and we suggested how the points and positions can be used for breasts measurements.

Image analysis software versus direct anthropometry for breast measurements

PURPOSE

To compare breast measurements performed using the software packages ImageTool(r), AutoCAD(r) and Adobe Photoshop(r) with direct anthropometric measurements.

METHODS

Points were marked on the breasts and arms of 40 volunteer women aged between 18 and 60 years. When connecting the points, seven linear segments and one angular measurement on each half of the body, and one medial segment common to both body halves were defined. The volunteers were photographed in a standardized manner. Photogrammetric measurements were performed by three independent observers using the three software packages and compared to direct anthropometric measurements made with calipers and a protractor.

RESULTS

Measurements obtained with AutoCAD(r) were the most reproducible and those made with ImageTool(r) were the most similar to direct anthropometry, while measurements with Adobe Photoshop(r) showed the largest differences. Except for angular measurements, significant differences were found between measurements of line segments made using the three software packages and those obtained by direct anthropometry.

CONCLUSION

AutoCAD(r) provided the highest precision and intermediate accuracy; ImageTool(r) had the highest accuracy and lowest precision; and Adobe Photoshop(r) showed intermediate precision and the worst accuracy among the three software packages.