Then, we gave these to volunteers randomly. To avoid bias, we made the 10 kinds of the questionnaires that the order of the panels of each question are different. We ensured the proportions by using the blocks of the same size (see figure, Supplemental Digital Content 2, which displays creation of illustrations, ). The illustrations were created using Photoshop CS 5.1 (Adobe Systems Corp., San Jose, Calif.) and Illustrator CS 5.1 (Adobe Systems Corp., San Jose, Calif.). What is the most ideal vertical proportion of the anterior breast? Choose between 45:55, 50:50, 55:45, 60:40, and 65:35 of the ratio between I–N level and N level–H. Upper anterior breast:lower anterior breast ratio = J:K. I: a point where a vertical line crossing H meets the upper breast slope. H: a point where the breast meets the abdomen. Vertical proportion of the anterior breast. The volunteers received the questionnaire in their native language. Female volunteers who had received or considered aesthetic surgery for augmentation or reduction were asked to answer “yes” to “ interest in breast aesthetic surgery”. Volunteers were asked to anonymously provide their demographic information, such as age, gender, and nationality before answering the survey questions. The questionnaire was given to the patients, the employees of our clinic, and their acquaintances by random selection after explaining the objectives of the study. Only Asian volunteers older than 19 years of age were allowed to take part in this study.īoth offline – a physical questionnaire – and online – a Google form ( ) – surveys were made available. We designed a cross-sectional questionnaire study. All voluntary respondents signed an informed consent before taking part in the study. This study complies with the Declaration of Helsinki on the Use of Human Subjects in Research. With this in mind, the authors have developed a new survey to better define the ideal breast shape and to analyze patient preferences of Asians. Although there are some studies to identify the esthetic standard for the face of Asians, 1, 14 the studies to identify ideal breasts for Asians are scarce, whereas several studies have been conducted to identify ideal breasts for Caucasians. For this reason, a proportional representation of ideal breast parameters may be a more sound approach than absolute numerical definitions. It must be noted, however, to be readily used to plan for surgeries, an ideal breast shape should not be defined only in terms of the breast itself, but rather in proportion to the rest of the body. Recent studies have analyzed breast shapes and nipple areola complex position that are perceived as natural and ideal by questionnaire study. 9Ī different study quantified an ideal anthropomorphic value of a female breast and reported that an ideal sternal notch-to-nipple distance was 21–21.5 cm, an ideal nipple-to-base distance was 6 cm, and an ideal base-to-inframammary fold was 2 cm. In one of the prior studies on the preference for the upper pole shape among plastic surgeons and patients, the survey reported that while the plastic surgeons preferred a concave shape, the patients who had undergone breast augmentation surgeries preferred a convex-shaped upper pole. 4– 6 Unfortunately, research on the ideal breast shape has been scarce due in part to the methodological difficulties of objectively assessing the breast. 1– 3 There have also been numerous researches on ideal body shapes, waist–hip ratios, etc., and they are effectively used as markers in gluteal surgeries. There have been many studies on various esthetic standards for facial surgeries. Developing a tool for objectively assessing the ideal breast shape will be a meaningful endeavor for practicing breast surgeons. For both cosmetic and reconstructive breast surgeries, the concept of an ideal breast shape must be clearly established in advance to allow precise planning and assessment of the surgical outcome. Defining the concept and the assessment standard of esthetics is the most important and fundamental step of performing an esthetics surgery.
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