Aesthetic Breast Surgery: What Do the Measurements Reveal?

BACKGROUND: Do plastic surgeons really know what happens to the breast after surgery? We often think that we do, but we have very few measurements to show whether we are on the right track. OBJECTIVES: Only when the surgeon can predict the changes can she or he achieve consistent outcomes. Measurements lead to understanding; understanding what the measurements show allows us to refine our approach. METHODS: Consecutive patients in four categories were analyzed: breast reduction, mastopexy, augmentation, and mastopexy-augmentation. All procedures were performed by a single surgeon and all measurements were performed by the same surgeon. A standard measuring tape was used and data was collected immediately preoperatively and at each follow-up visit. Only those patients with preoperative and a full one-year postoperative measurements were included in this review. The parameters measured were CLAV-UBB (clavicle to upper breast border), UBB-N (upper breast border to nipple), SSN-N (suprasternal notch to nipple), SSN-IMF (suprasternal notch to inframammary fold), and MID-N (chest midline to nipple). RESULTS: The changes were consistent. The borders of the breast footprint were expanded with the addition of an implant (UBB and IMF) and reduced with the removal of parenchyma (IMF). The existing SSN-N position was stretched when volume was added to the breast mound and it remained unchanged from the preoperatively marked position in a breast reduction. CONCLUSIONS: Although measurements are not necessary to achieve good aesthetic results in breast surgery, surgeons should understand what the measurements show and what happens to the different breast parameters.