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Abstract: Implant Bra Sizing: Are Patients Getting Accurate Information?

Small, Kevin MD; Costa, Christopher MD, MPH; Adams, William MD

Plastic and Reconstructive Surgery – Global Open: September 2016 - Volume 4 - Issue 9S - p 36
doi: 10.1097/01.GOX.0000511273.56907.dc
Saturday, September 24
Open

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

BACKGROUND: Bra sizing is a common method to preoperatively select implants for breast augmentation; however, no series has corroborated the accuracy of this modality with post-operative outcomes. Alternatively, previous investigations have validated the utility of three-dimensional imaging. This investigation utilizes three-dimensional analysis to determine if preoperative bra sizing provides equivocal information compared to surgical simulation for patient education and planning prior to a breast augmentation.

METHODS: During a primary breast augmentation consultation, patients received preoperative three-dimensional images and associated surgical simulations. Sizers, equivocal to the implants chosen in the simulation, were placed in a surgical bra, and three-dimensional images were repeated. Volumetric and contour analyses were compared between the surgical simulation and the bra/sizer image. All patients used a surgical bra (size small, 32–34) and smooth, round silicone sizers, average volume 302cc (Range 265-339cc).

RESULTS: 7 patients (14 breasts) underwent 3D imaging. The average volume of the bra/sizer image was 22.3% greater than the preoperative simulated breast image. The mean absolute difference of all surface points between the two breast images was 9.25mm (range, 5.98–11.96mm; standard deviation, 8.59). The maximum anterior displacement of the bra image from the simulated image was 19.52mm, centered at the upper pole; the maximum posterior displacement was 25.49mm, centered at the lower pole.

In comparison to three-dimensional simulation, pre-operative bra sizing not only overestimates the post-operative volume but also distorts the volumetric distribution and the anterior-posterior projection. This investigation outlines some deficiencies of bra sizing for patient education and informed consent in primary breast augmentation.

Copyright © 2016 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.