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Schafer HA, Leathers KO, Mumford KC, Ilangovan S, Vetter IL, Henry SL, Kelley BP, Torres-Guzman RA, Egeland BM. "Toward Breast Reinnervation- What is our Endpoint" A systematic review of normal breast sensibility. J Plast Reconstr Aesthet Surg 2024; 91:383-398. [PMID: 38461623 DOI: 10.1016/j.bjps.2024.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND To restore breast sensibility, some centers are offering nerve reconstruction as a component of implant and flap-based breast reconstruction. To interpret and contextualize the results of these procedures, it is necessary to understand the normal range of breast sensibility, the factors that affect it, and the best methods for its objective measurement. METHODS We conducted systematic and comprehensive searches across PubMed, Web of Science, and Cochrane Library databases using keywords and controlled vocabulary for the concepts of the breast, nipple, areola, and measurement. The search results were imported into Rayyan QCRI for a blinded screening of titles and abstracts. Studies were evaluated for bias using RevMan 5 software. The results of sensory measurements were pooled, and a quantitative summary of breast sensibility was generated. RESULTS A total of 36 articles were identified, including retrospective, cross-sectional, and prospective studies. Although there were some consistent findings across studies, such that breast sensibility is inversely related to breast volume, there was wide variability in the following parameters: population, breast condition, measurement modality, anatomic areas of measurement, and sensibility findings. This heterogeneity precluded the generation of normative breast sensibility measurements. Furthermore, we detected a high degree of bias in most studies, due to self-selection of participants and failure to record patient characteristics that may alter sensibility. CONCLUSIONS The literature lacks consistent data delineating normative values for breast sensibility. Standardized measurements of healthy volunteers with various breast characteristics are necessary to elucidate normative values and interpret efforts to restore sensibility in breast reconstruction.
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Affiliation(s)
- Helen A Schafer
- The University of Texas at Austin Dell Medical School, Austin, TX, USA; Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Kaylee O Leathers
- The University of Texas at Austin Dell Medical School, Austin, TX, USA; Department of Plastic Surgery, Ohio State University Medical Center, Columbus, OH, USA
| | - Kelsey C Mumford
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Sruthi Ilangovan
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Imelda L Vetter
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Steven L Henry
- The University of Texas at Austin Dell Medical School, Austin, TX, USA; Seton Plastic and Hand Surgery, Ascension Medical Group, Austin, TX, USA
| | - Brian P Kelley
- The University of Texas at Austin Dell Medical School, Austin, TX, USA; Seton Plastic and Hand Surgery, Ascension Medical Group, Austin, TX, USA
| | | | - Brent M Egeland
- The University of Texas at Austin Dell Medical School, Austin, TX, USA; Seton Plastic and Hand Surgery, Ascension Medical Group, Austin, TX, USA
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Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, Alp Dal N, Amaral ACS, Andrianto S, Anjum G, Argyrides M, Atari M, Aziz M, Banai B, Borowiec J, Brewis A, Cakir Kocak Y, Campos JADB, Carmona C, Chaleeraktrakoon T, Chen H, Chobthamkit P, Choompunuch B, Constantinos T, Crumlish A, Cruz JE, Dalley SE, Damayanti D, Dare J, Donofrio SM, Draksler A, Escasa-Dorne M, Fernandez EF, Ferreira MEC, Frederick DA, García AA, Geller S, George A, Ghazieh L, Goian C, Gorman C, Grano C, Handelzalts JE, Horsburgh H, Jackson T, Javela Delgado LGJ, Jović M, Jović M, Kantanista A, Kertechian SK, Kessels L, Król-Zielińska M, Kuan G, Kueh YC, Kumar S, Kvalem IL, Lombardo C, Luis López Almada E, Maïano C, Manjary M, Massar K, Matera C, Mereiles JFF, Meskó N, Namatame H, Nerini A, Neto F, Neto J, Neves AN, Ng SK, Nithiya DR, Omar SS, Omori M, Panasiti MS, Pavela Banai I, Pila E, Pokrajac-Bulian A, Postuvan V, Prichard I, Razmus M, Sabiston CM, Sahlan RN, Sarfo JO, Sawamiya Y, Stieger S, SturtzSreetharan C, Tee E, Ten Hoor GA, Thongpibul K, Tipandjan A, Tudorel O, Tylka T, Vally Z, Vargas-Nieto JC, Vega LD, Vidal-Mollón J, Vintila M, Williams D, Wutich A, Yamamiya Y, Zambrano D, Zanetti MC, Živčić-Bećirević I, Voracek M. The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations. Body Image 2020; 32:199-217. [PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/17/2022]
Abstract
The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
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Affiliation(s)
- Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia.
| | - Ulrich S Tran
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Reza Afhami
- Department of Art Studies, Tarbiat Modares University, Tehran, Iran
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Carlos A Almenara
- Institute for Research on Children, Youth, and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Nursel Alp Dal
- Midwifery Department, Munzur University, Tunceli, Turkey
| | - Ana Carolina Soares Amaral
- Federal Institute of Education, Science, and Technology of Southeast Minas Gerais, São Barbacena, Brazil
| | - Sonny Andrianto
- Department of Psychology, Islamic University of Indonesia, Yogyakarta, Indonesia
| | - Gulnaz Anjum
- Department of Social Sciences and Liberal Arts, Institute of Business Administration, Karachi, Pakistan
| | - Marios Argyrides
- School of Health Sciences, Neapolis University Paphos, Paphos, Cyprus
| | - Mohammad Atari
- Department of Psychology, University of Southern California, Los Angeles, United States
| | - Mudassar Aziz
- Department of Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Benjamin Banai
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Joanna Borowiec
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | | | | | - Carmen Carmona
- Department of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain
| | - Trawin Chaleeraktrakoon
- Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand
| | - Hong Chen
- School of Psychology, Southwest University, Chongqing, China
| | - Phatthanakit Chobthamkit
- Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand; School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Bovornpot Choompunuch
- Department of Educational Psychology and Counseling, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
| | | | - Aine Crumlish
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | | | - Simon E Dalley
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Devi Damayanti
- Department of Psychology, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Joanna Dare
- Department of Psychology, Chapman University, Orange, United States
| | - Stacey M Donofrio
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Anja Draksler
- Slovene Centre for Suicide Research, Andrej Marusic Institute and Department of Psychology FAMNIT, University of Primorska, Koper, Slovenia
| | | | | | | | | | | | - Shulamit Geller
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo, Yaffo, Israel
| | - Alexias George
- Department of Psychology, Panteion University of Athens, Athens, Greece
| | - Louai Ghazieh
- Department of Human Resources, Saint Joseph University, Beirut, Lebanon
| | - Cosmin Goian
- Department of Social Work, West University of Timișoara, Timișoara, Romania
| | - Colin Gorman
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Caterina Grano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Heather Horsburgh
- School of Social Sciences, University of Southampton, Southampton, United Kingdom
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
| | | | - Marija Jović
- Department of Marketing Management and Public Relations, University of Belgrade, Belgrade, Serbia
| | - Marko Jović
- Department of Plastic and Reconstructive Surgery, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Adam Kantanista
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | | | - Loes Kessels
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Magdalena Król-Zielińska
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | - Garry Kuan
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Sanjay Kumar
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | | | | | | | - Christophe Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Mandar Manjary
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Camilla Matera
- Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence, Florence, Italy
| | | | - Norbert Meskó
- Department of General and Evolutionary Psychology, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Hikari Namatame
- Department of Psychology, University of Tsukuba, Tsukuba, Japan
| | - Amanda Nerini
- Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence, Florence, Italy
| | - Felix Neto
- Department of Psychology, University of Porto, Porto, Portugal
| | - Joana Neto
- Department of Psychology, Catholic University of Brasília, Taguatinga, Brazil
| | - Angela Nogueira Neves
- Division of Research, Physical Education College of the Brazilian Army, Rio de Janeiro, Brazil
| | - Siu-Kuen Ng
- Physical Education Unit, Chinese University of Hong Kong, Hong Kong, China
| | - Devi R Nithiya
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeth, India
| | - Salma Samir Omar
- Department of Dermatology, Venereology, and Andrology, Alexandria University, Alexandria, Egypt
| | - Mika Omori
- Department of Psychology, Ochanomizu University, Tokyo, Japan
| | - Maria Serena Panasiti
- Santa Lucia Foundation, Scientific Institute for Research and Healthcare, Rome, Italy
| | | | - Eva Pila
- School of Kinesiology, University of Western Ontario, Ontario, Canada
| | - Alessandra Pokrajac-Bulian
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Vita Postuvan
- Slovene Centre for Suicide Research, Andrej Marusic Institute and Department of Psychology FAMNIT, University of Primorska, Koper, Slovenia
| | - Ivanka Prichard
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Magdalena Razmus
- Institute of Psychology, Marie Curie-Skłodowska University, Lublin, Poland
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jacob Owusu Sarfo
- Department of Nursing, All Nations University College, Koforidua, Ghana
| | - Yoko Sawamiya
- Department of Psychology, University of Tsukuba, Tsukuba, Japan
| | - Stefan Stieger
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria; Department of Psychology, Research Methods, Assessment, and iScience, University of Konstanz, Konstanz, Germany
| | - Cindi SturtzSreetharan
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | - Eugene Tee
- Department of Psychology, HELP University, Shah Alam, Malaysia
| | - Gill A Ten Hoor
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Kulvadee Thongpibul
- Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand
| | - Arun Tipandjan
- Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, India
| | - Otilia Tudorel
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Tracy Tylka
- Department of Psychology, Ohio State University, Columbus, United States
| | - Zahir Vally
- Department of Psychology and Counseling, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Luis Diego Vega
- Department of Psychology, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Jose Vidal-Mollón
- Department of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain
| | - Mona Vintila
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Deborah Williams
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | - Yuko Yamamiya
- Department of Undergraduate Studies, Temple University Japan, Tokyo, Japan
| | - Danilo Zambrano
- Department of Psychology, Fundación Universitaria Konrad Lonrez, Bogotá, Colombia
| | | | - Ivanka Živčić-Bećirević
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
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