The Ideal Breast
What’s ideal? What’s normal? Women’s breasts vary so widely that there really is no way to define the “normal.” Each person’s experience, cultural background and preferences create their personal “ideal” and there is remarkable difference of opinion. So what do plastic surgeons consider when trying to get the very best appearance for each woman choosing breast surgery? In order to communicate aesthetic ideas with their patients, plastic surgeons analyze basic characteristics of the breast and try to describe what features are possible to change and how to create the best surgical strategy for improvement. After your surgeon has listened well to your preferences, these are a few of the features that your surgeon may want to analyze with you.
Where is the breast located on the chest wall? The base of the breast (breast disc or footprint) should meet the chest wall in a way that is the foundation for the overlying three dimensional structure of the breast. This footprint is constant throughout life. An abnormal location of the footprint or an irregular chest wall can interfere with the aesthetics of the breast. Is your breast fold too high or too low? Is your spine straight? Does one side of the chest project more than the other? Are your ribs crooked?
- What is the shape or “conus” of the breast? Breast shape varies widely among women and quite a bit over a given woman’s lifetime. In adolescence the breast is cone shaped. Over time there should be a progressive transition with a greater portion of its volume resting in the lower outer quadrant. The nipple should be at the area of maximum breast projection, roughly at the apex of the cone shape.
- What is the quality and quantity of the breast skin? Too much skin leads to a drop in the breast position on the chest wall. The skin provides the major support for the breast gland. If elasticity is poor, the skin envelope cannot contain the gland in a suitable shape.
- Is the areola size a good match for the volume of the breast? Is the nipple position correctly located on the projecting portion of the breast and in the middle or slightly lateral to the middle of the breast?
- Do the two breasts look alike? Most women’s breasts are more like sisters than identical twins, but symmetry is one feature of the hoped for end result.
- Is the volume appropriate for the rest of the body’s proportions? You should express your size concerns to your surgeon and have a careful discussion about any possible downsides to your choice.
The term “TUBULAR” refers to SHAPE for a tubular breast. It is used to describe a breast shape that is long and narrow, rather than being broad at the base with a gradual decrease in width up to the top, like a cone or pyramid. Women that have tubular breasts often have a very high fold at the base of their breast, and they have puffiness in the nipple-areolar region where the breast seems to bunch out of the top. A mild tubular breast shape is quite common. Extreme tubular breast deformity can be very troubling to have, and women often want the shape improved.