What Makes a Difference? Three-Dimensional Morphological Study of Parameters that Determine Breast Aesthetics

Breast Augmentation Preferences and Concerns Among Chinese Women: A Nationwide Multicenter Study of 2066 Cases

BACKGROUND

Research studies on Asian women's preferences for breast augmentation and the factors that influence decision-making are scarce or unrepresentative.

METHODS

This study was conducted from September 2016 to September 2017, a period of one year. We developed a questionnaire for Chinese female with breast augmentation intentions based on the Breast-Q questionnaire, the world's most popular breast augmentation assessment tool, and conducted questionnaire surveys in 35 hospitals located in 19 provinces in mainland China among female who came to hospitals to inquire about breast augmentation surgery.

RESULTS

A total of 2066 questionnaires were collected from female interested in breast augmentation. The age range at the time of response was 19-53 years (mean 31.2 ± 6.8 years). More than half of the respondents (58.1%) were married, and 70.4% of them had children. The respondents rated their dressed image significantly higher than their nude image. Their partners also rated their breast image poorly, with 43% rating it fair and 30.4% negatively. Internal reasons, such as improving self-confidence and creating a better body image, were the main motivators for breast augmentation. More than half of the respondents had only limited understanding of breast augmentation surgery or had heard of it but did not fully understand it (33.2% and 27.5%, respectively), and 69.4% had considered breast augmentation for less than three years. A total of 49.2% of the respondents learned about breast augmentation surgery through the Internet. A total of 43.8% of the respondents did not receive support from family members or partners. Surgical safety (20.4%), surgical effect (17.1%), and surgeon's skill (16.6%) were given the highest priority. The surgeon's professionalism, popularity, and academic background were also high on people's list of considerations.

CONCLUSIONS

The results of our breast augmentation survey provide data on many Chinese women considering breast augmentation. This will help plastic surgeons better understand the characteristics, preferences, and concerns of Chinese women undergoing breast augmentation and will be used to guide patient-doctor communication and help Chinese women make the most informed decisions.

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 .

Three-dimensional Evaluation of Results After Dual-Plane Breast Augmentation with and Without Internal Suture Mastopexy

BACKGROUND

In patients with breast atrophy and ptosis, it is necessary to correct both problems simultaneously. This study aimed to analyze breast morphological changes with a three-dimensional (3D) scanning technique to demonstrate the improvement effect of dual-plane breast augmentation combined with internal suture mastopexy.

METHODS

3D breast surface scans were performed preoperatively and postoperatively in 24 patients (n = 35 breasts) undergoing internal suture mastopexy combined with prosthetic augmentation through the periareolar approach and 24 patients (48 breasts) undergoing simple dual-plane breast augmentation. Changes in linear distance, breast volume and volume distribution, breast projection, and nipple position were analyzed to assess the breast morphology.

RESULTS

Compared with simple breast augmentation, augmentation combined with internal suture mastopexy was associated with a higher upper pole volume increase and greater medial and upward nipple displacement. After the surgery, the upper pole volume increased by an average of 10.6% in combined augmentation group and decreased by an average of 2.2% in the simple breast augmentation group. The measured breast projections were 24.8 ± 2.2% lower than expected in the combined group and 23.1 ± 4.1% lower than expected in the simple group, based on implant parameters recorded by the manufacturer. The nipple moved 0.2 ± 0.5 cm laterally, 1.6 ± 0.6 cm upward, and 2.8 ± 0.7 cm anteriorly in the combined group and 0.9 ± 0.5 cm laterally, 0.7 ± 0.6 cm upward, and 3.0 ± 0.6 cm anteriorly in the simple group.

CONCLUSIONS

Dual-plane breast augmentation in addition to internal suture mastopexy appears to reposition breast tissue from the lower pole to fill in the deficient upper breast, pull the nipple medially and superiorly, and ultimately correct mild to moderate breast ptosis.

LEVEL OF EVIDENCE III

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 .

Breast Morphological Changes after Transaxillary Dual-Plane Augmentation with Smooth Round Implants: A Prospective Study

BACKGROUND

Breast augmentation is the most performed cosmetic surgery in the world. Although smooth round implants are widely used, the trend in breast morphology change after dual-plane augmentation with such implants remains unclear. In this study, we analyzed the issue with the support of 3D scanning technology, which may help provide an objective basis for the evaluation of postoperative outcomes and the determination of follow-up time points.

METHODS

Patients undergoing dual-plane augmentation with smooth round implants were prospectively included in this study. The variation trend of postoperative breast morphology was analyzed by measuring the specified linear distance, body surface distance, breast projection, nipple position and breast volume at different follow-up time points (1st month, post-1M; 3rd month, post-3M; 6th month, post-6M; 12th month, post-12M).

RESULTS

A total of 18 patients were included in this study. During the postoperative follow-up period, breast height prolonged while interval of the medial border gradually widened. Breast width was maintained without significant alterations from post-1M. The N-MBB lengthened with shortening of the N-LBB, meanwhile the N-IMF was prolonged by 0.6 cm. Breast volume was gradually reduced with the decrease in breast projection. The position of the nipple gradually shifted laterally, superiorly, and posteriorly after surgery. There was no statistically significant difference between the linear distance at post-3M and post-12M, while the surface distance, breast projection, nipple position and breast volume tended to be stable at post-6M.

CONCLUSIONS

After dual-plane augmentation with smooth round implants, the base contour of the breast shifted outwards and downwards, and stabilized after 3 months. The remaining breast morphological parameters reached a relative steady state by post-6M, which could be regarded as the time point for objective evaluation of postoperative effect.

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 .

A Simple Preoperative Marking of Implant Augmentation Mammoplasty: The Semicircle Method

BACKGROUND

The location of the inframammary fold is the most critical step in the preoperative marking of implant augmentation mammoplasty. At present, most of the calculation formulas for new inframammary fold location determination are complicated.

OBJECTIVE

Based on the aesthetic standards of the breast, we proposed a simple and effective method, the Semicircle method, to determine the location of the new inframammary fold.

METHODS

In this prospective study, 21 patients were enrolled to record the distance from the nipple to the new inframammary fold calculated by the Semicircle method, Tebbetts method, Randquist method, Mallucci's ICE method and compare the Semicircle method to the other three methods by using the intraclass correlation coefficient.

RESULTS

According to the statistical results of the intraclass correlation coefficient, the Semicircle method had poor consistency with the Tebbetts and ICE methods, but good consistency with the Randquist method.

CONCLUSION

The Semicircle method is a simple and aesthetically acceptable design method for breast augmentation mammoplasty, which can quickly and efficiently determine the position of the new inframammary fold. At the same time, this method has good consistency with the Randquist method and can obtain satisfactory breast morphology.

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 .

An Aesthetic Factor Priority List of the Female Breast in Scandinavian Subjects

There is little consensus about the relative determinative value of each individual factor in female breast aesthetics. When performing breast surgery with an aesthetic goal, certain factors will be more important than others. The purpose of this study was to make an aesthetic factor rank list to determine the relative contributions to overall breast aesthetics.