The Three Breast Dimensions: Analysis and Effecting Change

Background: This article reviews the three breast dimensions and how they can be changed. The first two dimensions constitute the breast footprint. The third dimension is the shape of the breast on the footprint. Methods: All four breast footprint borders are reviewed along with the third dimension, which is the breast shape and how it sits on that footprint. An analysis of the "normal" position of the footprint and the "normal" shape of the breast is given. It is important for the surgeon to understand how change in each of the parameters can be effected. The upper and lateral breast borders are relatively mobile, but the inferior and medial breast borders are relatively fixed. All four borders can be changed with certain surgical maneuvers, and these have been measured and analyzed. The breast is a skin structure that is held in place by skin/fascial zones of adherence, and the breast itself is mobile over the pectoralis fascia. Results: Measurements before and after breast augmentation, breast reduction, mastopexy, and mastopexy-augmentation have been obtained so that the surgeon can better predict results. The change in suprasternal notch-to-nipple distance and the change in suprasternal notch-to-inframammary fold distance have been measured. Conclusion: Being able to explain the issues and the potential changes makes it easier for a surgeon to manage patients' expectations. (Plast. Reconstr. Surg. 125: 1632, 2010.)