Contribution of breast density to the volume of the augmented breast: A preliminary study

Breast reconstruction and augmentation plays an important role in the field of plastic surgery. The procedure can help a woman feel complete, and can re-establish her emotional balance and self-esteem after suffering through a horrifying battle. Breast augmentation is one of the five most common procedures performed by plastic surgeons (1). Women undergo this procedure for mainly two reasons: bilateral hypoplasia of the breast or asymmetry of the breasts due to breast reconstruction of the contralateral side as a consequence of cancer surgery. In both situations, it is most important to try to meet the patient’s expectations and to create two symmetrical breasts. In previous years, breast reconstruction and augmentation has relied on the surgeon’s subjective appreciation of breast tissue characteristics matched with technique and knowledge of wound healing to achieve an aesthetically pleasing result. Currently, three-dimensional digital analysis offers the ability to objectively define anatomical subtleties to refine surgical technique through its capacity to calculate breast volume, surface area, shape, size and contour (2). Baseline volume data can be objectively collected before deciding on the correct implant size to match the cancer-free breast. To improve the outcome of breast augmentation, factors such as patient age and breast density on mammogram must be evaluated. The purpose of the present study was to objectively measure the truly created breast volume (using three-dimensional photography) and compare it with the implant size used for augmentation; furthermore, the study compared the results with breast density on mammogram. The resulting volume and the actual implant size used for augmentation were subsequently compared with breast density on mammogram. The hypothesis was that a younger, more dense breast results in compression of the breast implant and, therefore, leads to smaller true breast volumes when compared with the implant size.