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A Novel Method of Patient Breast Assessment Photography Using a Mirror

Sasaki, Ayano, M.D.; Nagamatsu, Shogo, M.D., Ph.D.; Fujioka, Yumio, M.D.; Yokota, Kazunori, M.D., Ph.D.

Plastic and Reconstructive Surgery: October 2017 - Volume 140 - Issue 4 - p 640e-641e
doi: 10.1097/PRS.0000000000003737

Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan

Correspondence to Dr. Nagamatsu, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan,

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Body image for women, especially after breast surgery, might change. Therefore, it is crucial to objectively and subjectively assess the breast shape. Accurately recording and assessing breast shape, size, and proportion using available methods, including direct physical measurement, simple photographic recording, computed tomography, magnetic resonance imaging, and three-dimensional imaging, is difficult.1–4 Currently, no standard method exists for objectively assessing breast size and shape. Photographic recording is simple, easy to perform, and reliable, but it is planar and contains only two-dimensional data. Ultrasonography, computed tomography, magnetic resonance imaging, and other imaging modalities have their own limitations, advantages, and disadvantages. Three-dimensional imaging is expensive and requires a computer for viewing results.

We developed a novel method of taking patient photographs that provide the patient’s view of the breast—the view that the patient has when looking down—and her body. A plastic mirror costs less than $50. We continued using the preexisting camera, a digital single-lens reflex camera with a macro lens and ring flash, at our institution. This method is technically uncomplicated, inexpensive, and easy to set up.

A large 40 × 30-cm mirror made of lightweight plastic was the only item purchased. When taking photographs from different viewpoints, including frontal, left and right oblique, and left and right lateral views, patients were requested to stand erect and hold the mirror at approximately 45 degrees to reflect the body view toward the floor (Fig. 1). The mirror angle was adjusted so that the photographer could see the upper breast side. One edge of the mirror was held against the sternal notch to maintain the photographic composition. A lightweight mirror was advised for patient comfort and safety; some background-neutral material was placed on the patients’ feet, which would otherwise have been visible in the mirror. Using this method, breast shape, size, and proportion could be assessed from two directions in one photograph (Fig. 2).

Fig. 1.

Fig. 1.

Fig. 2.

Fig. 2.

In breast surgery, accurately assessing breast shape, size, and proportion is important.1,2 The development of new imaging modalities is ongoing, but no standard method exists for objectively assessing breast morphology. Photographic recording is a traditional and widely used method in plastic surgery.3 However, photographs provide a planar view and contain only two-dimensional data. Before-and-after comparisons are possible, and photographs do not require computers or special equipment for viewing. The use of photography and mirrors during mammaplasty and in nasal operations has been reported2,5; however, the methods used were not the same as the method described here. Patients and plastic surgeons can have different body image perceptions, including natural and ideal breast shape. The photographic method described here is a simple method for visualizing the patient’s view of the breasts while taking photographs. The image from the patient’s view angle may not be familiar to the surgeon, and valuable information could be made available about the patient’s potential self-assessment. This method is simple, inexpensive, and easy to perform, and can be routinely used for recording body shape. Its use will potentially change the methods for assessing breast surgery and other cosmetic surgery.

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The authors have no financial or other conflicts of interest to declare in relation to the content of this article.

Ayano Sasaki, M.D.Shogo Nagamatsu, M.D., Ph.D.Yumio Fujioka, M.D.Kazunori Yokota, M.D., Ph.D.Department of Plastic and Reconstructive SurgeryHiroshima University HospitalHiroshima, Japan

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Copyright © 2017 by the American Society of Plastic Surgeons