Breast reduction

Penn, Jack

doi:10.1016/s0007-1226(54)80046-4

Cited by 134 publications

(21 citation statements)

References 2 publications

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“…Since the 1950s, plastic surgeons have sought to define and create standardized methods to achieve the aesthetic breast. 8 Atiye et al 15 tactfully described the importance of defining aesthetic proportions: “body proportions can vary greatly... nevertheless, understanding geometric anthropometric proportions and their relationship with beauty as well as defining objectively the ideal aesthetic morphology constitute invaluable and fundamental guidelines for setting the goals of surgery.” After establishing 45:55 as the ideal breast ratio, Mallucci and Branford 16 later published an article detailing a mathematical formula and surgical techniques to achieve the 45:55 ratio with different implant types. When these aesthetic proportions are respected with proper measurements, perceived beauty is enhanced and optimal aesthetics are achieved.…”

Section: Discussionmentioning

confidence: 99%

Morphometric Analysis of Gender-affirming Breast Augmentation

Song

Parmeshwar

Steiner

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: According to cisgender respondents, the “preferred” feminine breast has a 45:55 upper-to-lower pole ratio. Preferred breast ratios have not been evaluated for transgender women undergoing breast augmentation. Therefore, this study aimed to determine the preferred breast ratio according to the transgender population and, thus, better inform surgeon planning. Methods: Patients diagnosed with gender dysphoria were sent a survey with morphed breast images of four different upper-to-lower pole ratios: 35:65, 45:55, 50:50, and 55:45. Respondents ranked the images according to aesthetic preference. Rankings were analyzed by the Condorcet method. Results: 298 survey responses were analyzed: 197 (66.1%) respondents identified as transgender women and 31 (10.4%) as transgender men. Most respondents were younger than 40 (64.8%). Eighty-one (27.2%) had undergone breast augmentation, 136 (45.6%) had not and were not considering it, and 81 (27.2%) had not but were considering it. Across all subgroups, the most preferred ratio was 45:55 (P = 0.046). Those with more masculine genders and assigned female at birth preferred the 45:55 and 50:50 ratios equally. Those in their 30's and younger preferred the 45:55 and 50:50 ratios equally. Conclusions: The 45:55 ratio, established as the most preferred morphometrics for breast augmentation by cisgender respondents, is also the most aesthetically preferred proportion among transgender patients. Interestingly, the 50:50 ratio, which projects a larger upper bust compared to the 45:55 ratio, may be equally or more appealing to younger patients and those with more masculine genders. We hope these results improve patient-physician shared decision-making and postoperative expectations.

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Section: Discussionmentioning

confidence: 99%

Morphometric Analysis of Gender-affirming Breast Augmentation

Song

Parmeshwar

Steiner

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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“…In a landmark study performed single-handedly by Penn 11 in 1954, the static 21-cm notch-to-nipple distance was introduced. In the study, 20 of 150 volunteers were selected for being “aesthetically perfect or nearly so.” Measures were then performed from sternal-notch-to-nipple and 8–8.5 inches (20.32–21.59 cm) seemed to occur frequently.…”

Section: Discussionmentioning

confidence: 99%

“…This is evidenced by the fact that (1) unilateral Fibonacci breasts are rated more highly than unilateral 21-cm nipple-to-notch breasts; (2) symmetric pairs of Fibonacci breasts are rated more highly than symmetric 21-cm notch-to-nipple pairs; and (3) unilateral breasts that belong to symmetrical pairs do not score better than individually aesthetic breasts that do not belong to a symmetrical pair. 12 In a landmark study performed single-handedly by Penn 11 in 1954, the static 21-cm notch-to-nipple distance was introduced. In the study, 20 of 150 volunteers were selected for being "aesthetically perfect or nearly so."…”

Section: Discussionmentioning

confidence: 99%

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Beyond the 21-cm Notch-to-nipple Myth: Golden Proportions in Breast Aesthetics

Sandberg

Tønseth

Kloster-Jensen

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: The 21-cm notch-to-nipple distance has been accepted without academic scrutiny as a key measure in breast aesthetics. The Fibonacci sequence and phi ratio occur frequently in nature. They have previously been used to assess aesthetics of the face, but not the breast. This study aims to assess if the static 21-cm measure or the proportional phi ratio is associated with ideal breast aesthetics. Method: Subclavicular-breast height and breast width were used to calculate the aesthetic ratio. Subjects were subsequently aesthetically rated. A one-sample t-test was used to determine if the ratio for each breast differed from phi. Breast scores with one, both, or no breasts were compared with an optimal phi ratio. Analysis of variance was performed. Tukey–Kramer adjustment for multiple comparisons was used when pairwise comparisons were conducted. Results: Five subjects (14%) had bilateral optimal phi ratio breasts. Four subjects (11%) had one breast with an optimal phi ratio. Subjects with bilateral optimal phi ratios had significantly higher overall breast scores than those with only one optimal breast (Δ = 0.86, P = 0.025) or no optimal breast (Δ = 0.73, P = 0.008). Distance from optimal Fibonacci nipple position was moderately to strongly correlated with aesthetic score (−0.630, P = 0.016). No correlation was found between 21-cm notch-to-nipple distance and aesthetic score. Conclusion: The bilateral optimal phi ratio is correlated with high overall aesthetic scores, as is the optimal Fibonacci nipple position. No correlation was found between 21-cm notch-to-nipple distance and overall aesthetic score.

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“…Learning more about female breasts can improve the understanding of women's physical and mental health 6 . The first to evaluate the breast by direct anthropometry was Penn in 1955 7 . Since then, different authors have published studies aimed at developing protocols for breast measurement by direct anthropometry and at highlighting the limitations of such measurements 4,[8][9][10][11][12][13][14] .…”

Section: ■ Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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Breast reduction

Cited by 134 publications

References 2 publications

Morphometric Analysis of Gender-affirming Breast Augmentation

Morphometric Analysis of Gender-affirming Breast Augmentation

Beyond the 21-cm Notch-to-nipple Myth: Golden Proportions in Breast Aesthetics

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

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