Sternal notch to nipple measurement - what does this mean in terms of augmentation?

Question

My doctors says my sternal notch to nipple measurement is short (15cm) what does that mean in terms of my augumentation though? Is that a bad thing? My nipple is slightly above halfway between my shoulder and elbow. My surgeon also said my breast had a nice shape, so im just wondering how important that measurement is. Im 24yrs old, only having my preop appointment in feb when the clinic opens again.

Ted Eisenberg, DO, FACOS, FAACS · Answer

One meaning implies a shorter torso a fact which implies you would not need as big an implant to get more fullness, or size, for a bigger look. The same size implant you choose would look smaller on someone with a long torso. It's not good nor bad. It's just a measurement that gives your surgeon information. Good luck. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Jeffrey M. Darrow, MD · Answer

A “normal“ sternal notch to nipple distance is 18 to 22 cm. If your sternal notch to nipple distance is 15 cm, it means that your breasts sit higher up on your chest. This impacts the choice of your breast implant size because as implants get larger, they also get wider/taller and the top of larger implants will appear to be closer and closer to your clavicle if the implant is positioned correctly behind your nipple.  You should have a detailed discussion about what implants would fit best for you and look most proportional for you with your plastic surgeon.

Yucel Sarialtin, MD · Answer

The sternal notch–to–nipple (SN–N) distance is one of the standard measurements we use when planning breast surgery, but it is not a “good vs. bad” score on its own.
In many patients, a shorter SN–N measurement (such as 15 cm) can be consistent with a higher nipple position and good skin/support, but the decision about whether you need augmentation alone versus augmentation plus a lift (mastopexy) is based on the full examination, especially:
Where the nipple sits relative to the inframammary fold (breast crease)
Degree of skin laxity and breast tissue distribution
Your chest/breast width measurements and your aesthetic goals
In general:
If the nipple is clearly above the inframammary fold and there is minimal laxity, many patients can do well with implant augmentation alone.
If the nipple is at or below the fold, or there is significant laxity, a lift with or without an implant may be required to achieve the desired shape.
Your surgeon’s in-person assessment will determine the most appropriate plan for your anatomy and goals.
Warm regards,Op. Dr. Yücel Sarıaltın, MDPlastic, Reconstructive & Aesthetic Surgeon

Daniel Barrett, MD · Answer

Dear Gorgeous7400,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jacob Carlson, MD · Answer

It’s more important to take all the measurements into consideration as a whole rather than as an isolated number. A sternal notch-to-nipple distance of 15cm just means that height of your chest may be ‘shorter’ than average, but it needs to be used along with the other measurements to determine the appropriate implant to use for your case. In our assessments, we will usually take measurements from the sternal notch to the nipple, nipple to inframammary fold, and the width of the breast. Some surgeons will also measure the distance between the nipples. Using those measurements, we are in a better position to determine which implant size and profile to use to accomplish the look that you want.

Donovan Rosas, MD · Answer

Sternal notch to nipple distance (SNN) is typically used to determine the appropriate position of the NAC when planning/marking a mastopexy/lift.

Classically, the most aesthetic nipple location was said to be at the two basal angles of an imaginary equilateral triangle with its apex at the sternal notch and each side measuring 21 cm.

In terms of augmentation, SNN is less crucial for operative planning.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Sternal notch to nipple measurement - what does this mean in terms of augmentation?

Answers (6)

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