Breast Augmentation Surgery—Is There a Golden Ratio to Follow?


Contrary to popular belief, breast augmentation is not all about using implants to augment the bust size. Perhaps a more important goal is to recreate the natural proportion and shape of the breast, rather than make it appear too rounded, which is a dead giveaway that some artificial material is underneath the skin.

Simply put, a great breast augmentation result looks natural and “subtle” and does not “shout” plastic surgery.

But is there a golden ratio skilled plastic surgeons follow when it comes to breast augmentation surgery? If yes, what are the techniques to simulate or reflect phi or the golden number 1.68?

Studies after studies have suggested that the ideal breast proportion resembles a teardrop, which simply means that most of the fullness is in the lower aspect of the breast, while the upper cleavage is somewhat concave in shape.

But one study is bold enough to specifically state the ideal or perfect breast proportion based on “popularity contest,” meaning the researchers asked more than 1,300 respondents from different walks of life, ethnicities, gender, and age brackets who mostly agreed that the upper pole to lower breast pole of 45:55 was the best shape.

The study, which was recently published by the Plastic and Reconstructive Surgery journal, involved photographs of breasts of varying sizes and proportions: 35:65, 45:55, 50:50, and 55:45. The areola complex or the pigmented part of skin was used as the dividing mark between the upper and lower poles.

This “finding” has always been a guiding principle of any skilled breast augmentation surgeon who has an eye for detail.

While some patients may not achieve the perfect 45:55 ratio due to their underlying anatomies, a good surgeon will make every effort to at least create a teardrop shape in which the lower pole has most of the fullness, while the upper pole has a small to moderate amount of roundedness.

The vertical and horizontal placement of breast implants is one of the most important factors affecting the postop appearance and proportions. A good rule of thumb is to place them centrally behind the areola complex and let the gravity work its effect on the filler material (saline or silicone gel).

Even with the use of round breast implants, which are shaped like an M&M candy, recreating the natural teardrop shape remains possible because the gravity pulls most of the filler material to the bottom of the implant shell, leading to more roundedness in the lower poles.

Aside from the natural teardrop shape, a breast that has a slightly lateral bulge is also deemed attractive. This is something that can be achieved by using an implant base that is similar or at least near equal to the breast and chest width.

To recap, the best way to achieve natural breast augmentation results is to get various measurements of the breast and chest. Of course, other factors such as the patient’s cosmetic goals, amount of existing tissue, body frame, lifestyle are also taken into account.
Article by
Beverly Hills Plastic Surgeon