Vertical breast measurement in East Asian women: A guide for mastopexy and reduction to form nonptotic breasts in unilateral prosthetic breast reconstruction

Background: Following unilateral breast cancer surgery, mastopexy and reduction of the unaffected breast are often performed to obtain symmetrical breasts. The use of implants in breast reconstruction results in a nonptotic breast. To achieve symmetry following the procedure, the unaffected side should be nonptotic too. However, no study has yet reported any indices for the design of mastopexy and reduction in this direction. We present a new method of preoperative design that uses vertical breast measurements to form nonptotic breasts according to individual breast shapes. Methods: We performed vertical breast measurements of the unaffected breasts of 193 patients scheduled to undergo surgery for unilateral breast cancer. The vertical base dimension (VBD) and vertical surface dimension (VSD) of the ptotic and nonptotic breasts and the height of the nipple in the nonptotic breast were measured in centimeters. Results: The borderline between ptotic and nonptotic breasts was expressed using the formula VSD = 1.13 x VBD + 1.86. The height of the nipple in nonptotic breasts was 0.8 times the distance between the sternal notch and lowest point of the inframammary fold on the midline. From these findings, we formulated a new method for forming a nonptotic breast from a ptotic breast using an inverted T design. Conclusion: These results can be used for the design of mastopexy and reduction when forming a nonptotic breast on the unaffected side. These procedures can be performed without significantly lifting the nipple-areolar complex if required during unilateral prosthetic breast reconstruction. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.