Exploring the Ideal of Breast Beauty: A Morphometric Analysis Based on the Opinions of the Brazilian Population.

Background The quest to identify parameters deemed optimal for breast aesthetics holds paramount significance in both aesthetic and reconstructive surgery. The definition of ideal breast beauty, however, is subject to cultural variations and diverse standards, necessitating a detailed understanding. Objective This study delves into the perspectives of the Brazilian population regarding the aesthetics of the female breast. Methods A selection of images portraying variations in the distribution of upper and lower pole ratios across four distinct proportion models (35:65, 45:55, 50:50, and 55:45) was presented to participants. Through a meticulously crafted questionnaire administered via Google Forms, respondents were tasked with identifying the images they deemed most beautiful and attractive. Comprehensive demographic data of the study participants were gathered and subsequently correlated with their group-specific opinions. Results A total of 3744 questionnaire responses were collected 228 of which were from plastic surgeons/residents. The average age was 35 years, with 55.3% being women. Notably, breasts featuring a ratio of 45:55 emerged as the consensus choice for the epitome of beauty, garnering preference from 73% of the general population, 68% of women, 78% of men, and an equal 78% of plastic surgeons. This preference was consistent across all regions of the country. Conclusion Breasts with a ratio of 45:55 were universally deemed the most aesthetically pleasing. Similarly, breasts with a 50:50 ratio of breast tissue emerged as the next preferred choice. These insights contribute valuable perspectives on aesthetic considerations in breast surgery within the unique cultural context of Brazil.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Impact of breast augmentation on female sexuality.

INTRODUCTION: The breasts are symbols of femininity, sexuality, and maternity. Breast augmentation is among the most sought-after procedures for women and has a positive impact on quality of life. Sexuality is one of the items that contribute to increased quality of life. Surgical outcomes can be evaluated from the patients' perspective using developed and validated questionnaires. For the assessment of sexuality, the most commonly used instruments are the Female Sexual Quotient and the Female Sexual Function Index, which estimate several domains of sexuality and can be used to evaluate the impact of surgery on it. OBJECTIVE: The objective of this study was to evaluate the impact of breast augmentation on female sexuality. METHODS: We selected 87 patients from the Plastic Surgery Outpatient Clinic of Hospital São Paulo (Federal University of São Paulo) who wished to undergo breast augmentation. The patients were classified into two groups: the Female Sexual Quotient questionnaire was applied to one group, and the Female Sexual Function Index questionnaire was applied to the other group to evaluate sexuality preoperatively as well as at 2 and 4 months postoperatively. RESULTS: In both groups, there was a significant increase in the total score of the Female Sexual Quotient and Female Sexual Function Index questionnaires, and an individual increase in each domain assessed, with a significant increase in the domains of orgasm and sexual satisfaction, as well as foreplay and arousal, indicating an improvement in the patients' sexuality postoperatively. CONCLUSION: Breast augmentation has a positive impact on female sexuality; furthermore, the Female Sexual Quotient and Female Sexual Function Index are sensitive in detecting this impact.

Impact of breast augmentation on female sexuality

SUMMARY INTRODUCTION: The breasts are symbols of femininity, sexuality, and maternity. Breast augmentation is among the most sought-after procedures for women and has a positive impact on quality of life. Sexuality is one of the items that contribute to increased quality of life. Surgical outcomes can be evaluated from the patients' perspective using developed and validated questionnaires. For the assessment of sexuality, the most commonly used instruments are the Female Sexual Quotient and the Female Sexual Function Index, which estimate several domains of sexuality and can be used to evaluate the impact of surgery on it. OBJECTIVE: The objective of this study was to evaluate the impact of breast augmentation on female sexuality. METHODS: We selected 87 patients from the Plastic Surgery Outpatient Clinic of Hospital São Paulo (Federal University of São Paulo) who wished to undergo breast augmentation. The patients were classified into two groups: the Female Sexual Quotient questionnaire was applied to one group, and the Female Sexual Function Index questionnaire was applied to the other group to evaluate sexuality preoperatively as well as at 2 and 4 months postoperatively. RESULTS: In both groups, there was a significant increase in the total score of the Female Sexual Quotient and Female Sexual Function Index questionnaires, and an individual increase in each domain assessed, with a significant increase in the domains of orgasm and sexual satisfaction, as well as foreplay and arousal, indicating an improvement in the patients' sexuality postoperatively. CONCLUSION: Breast augmentation has a positive impact on female sexuality; furthermore, the Female Sexual Quotient and Female Sexual Function Index are sensitive in detecting this impact.

Retropectoral Fat Graft Survival in Mammoplasty: Evaluation by Magnetic Resonance Imaging.

BACKGROUND: Fat grafting is used in combination with mammoplasty to improve filling of the upper pole of the breasts. Its effectiveness remains in question due to unpredictable results. Difficulty in isolating the grafted fat and differentiating it from host tissues may hinder assessment of graft integration. The plane between the pectoral muscles is free of fat and has already been described with respect to placement of breast implants and fat grafting in breast surgeries. This study sought to evaluate via magnetic resonance imaging (MRI) the integration and retention of retropectoral fat grafts in mammoplasty. METHODS: Thirty patients with breast flaccidity who desired to undergo mammoplasty were selected. Fat collected from the abdomen was separated by sedimentation and transferred to the retropectoral region after undermining of the breast and resection of excess tissue. The patients underwent MRI preoperatively and at three and six months after surgery. Fat volumes were calculated by multiplying the values for the major vertical, horizontal, and anteroposterior axes by the constant 0.523. RESULTS: Twenty-five patients completed the study. The mean volume grafted was 116.4 ± 22.5 ml per breast. Six months after surgery, the mean fat graft volume in the retropectoral plane was 48.1 ± 25.71 ml, and the integration rate was 40.82% (range, 32.2-49.4%). The rate of complications related to fat grafting was 8%. CONCLUSIONS: In mammoplasty, retropectoral fat grafting showed good integration rates and is a safe and predictable approach that can contribute to improving the outcomes of aesthetic and reconstructive breast surgeries. LEVEL OF EVIDENCE IV, COHORT ANALYTIC STUDY: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of Retropectoral Fat Grafting in Breast Reduction by Magnetic Resonance Imaging: A Pilot Study.

BACKGROUND: One of the challenges in breast reduction is to maintain breast projection with 45% of its volume in the upper pole and 55% in the lower pole. Although widely used in breast surgeries, the behavior of fat grafts is still not completely understood. OBJECTIVES: To evaluate by magnetic resonance imaging (MRI) the survival of fat transferred to the retropectoral plane in patients undergoing breast reduction, in the search for an oncologically safe procedure with high predictability and reproducibility. METHODS: This pilot study was conducted with 7 patients who underwent breast reduction combined with fat grafting in the submuscular plane. Aspirated fat was processed by sedimentation. MRI of the breasts was performed preoperatively and at 1 and 6 months postoperatively. Fat survival was calculated as the difference between the volumes of fat measured preoperatively and postoperatively by MRI divided by the volume of grafted fat. RESULTS: Fourteen breasts were operated on and received on average 119.6 mL of autologous fat in the submuscular plane. Fat survival rate was 43.9% at 1 month after surgery, decreasing to 23.4% in the late postoperative period. The mean anteroposterior projection of the grafted tissue was 1.51 cm at 1 month postoperatively, decreasing to 1.07 cm in the late postoperative period. CONCLUSIONS: Retropectoral fat grafting may contribute to maintaining the fullness of the upper pole of the breasts. This is an innovative experimental model for future studies on fat harvesting, preparation, and grafting techniques, allowing the evaluation of fat graft survival.

Sexualidade após mamoplastia de aumento / Sexuality after breast augmentation

Introdução: A mama é símbolo de feminilidade, maternidade e sexualidade. Mamoplastia de aumento é a segunda cirurgia estética mais realizada no Brasil, e está relacionada à melhora da imagem corporal, autoestima e qualidade de vida. Sexualidade é importante componente da qualidade de vida. O quociente sexual feminino (QS-F) é questionário desenvolvido e validado que avalia sexualidade, aplicado para avaliar o impacto do tratamento na saúde sexual. Consiste em 10 questões, que avaliam quatro domínios: desejo, excitação, conforto e satisfação sexual. O objetivo é avaliar a sexualidade após mamoplastia de aumento. Métodos: 47 candidatas a aumento das mamas foram selecionadas, tratadas cirurgicamente, e responderam ao questionário QS-F no pré e no pós-operatório de 2, 4 e 18 meses. A técnica adotada foi semelhante para todas pacientes: incisão no sulco mamário, loja subglandular, implante redondo entre 260 e 325 mL. Foram formados os grupos: com ou sem relacionamento estável; e com ou sem estrias. Resultados: 45 pacientes concluíram o estudo, com idade média de 26 anos. As complicações observadas foram: simastia (1), galactorreia (1), e estrias (10). Houve melhora significante entre o escore total do QS-F no pré e no pós-operatório de 4 (p = 0,001) e 18 meses (p = 0,001), relacionado ao significante aumento da pontuação dos domínios excitação (p < 0,001) e satisfação sexual (p = 0,001). Nas pacientes que apresentaram estrias não houve melhora significante da sexualidade (p = 0,627), ao contrário das que não apresentaram (p < 0,001). Não houve diferença significante na sexualidade entre o grupo com ou sem relacionamento estável. Conclusão: A sexualidade aumentou significantemente após mamoplastia de aumento.

Introduction: The breasts are symbol of femininity, motherhood and sexuality. Breast augmentation is the second most performed cosmetic surgery in Brazil, and it is related to improvement of body image, self-esteem and quality of life. Sexuality is a significant component of quality of life. The female sexual quotient questionnaire (FS-Q) was validated as an evaluation tool for sexuality, and it is used to evaluate the impact of many treatments for sexual health. The questionnaire entails 10 questions, which assess four domains of sexuality: sexual desire, sexual arousal, comfort and sexual satisfaction. To evaluate sexuality after breast augmentation. Methods: We selected 47 patients with interest in breast enlargement. During treatment patients completed the FSQ questionnaire before and after 2, 4 and 18 months of the surgery. The surgical technique used was the same for all patients: inframammary incision, subglandular pocket, round implant, volume 260 to 325 mL. There were four groups: with or without stable relationship, and with or without striae. Results: A total of 45 patients were considered for the study. Patients' mean age was 26 years. Complications observed were: symmastia (1), galactorrhea (1), and striae distensae(10). Significant improvement was observed between the total FSQ score at preoperative, 4 months (p = 0.001), and postoperative, 18 months (p = 0.001), and also related with the significant increase in arousal scores (p < 0.001), and sexual satisfaction (p = 0.001). Patients with striae did not show significant improvement in sexuality (p=0.627), differently of patients without striae (p < 0.001). No significant difference in sexuality was seen between the group with or without stable relationship. Conclusion: Sexuality increases significantly after breast augmentation.

Sexuality in Aesthetic Breast Surgery.

BACKGROUND: The breasts are important for a woman's psychological well-being, which may be negatively affected by distortions of breast size and shape. Improvements in self-esteem and sexuality are important psychological factors associated with motivation for cosmetic surgery. Mammaplasty is among the most sought-after and performed cosmetic procedures. The aim of this study was to evaluate the impact of aesthetic breast surgery on a woman's sexuality. METHODS: This study was conducted in a plastic surgery clinic of a hospital university in Brazil, between 2009 and 2012. Forty-six patients with hypomastia and 30 patients with breast hypertrophy, who expressed the desire for aesthetic breast surgery, were selected for the study. The patients were assessed preoperatively and 6 months postoperatively using the sexual quotient-Female version scale (QS-F). The QS-F is a validated Brazilian questionnaire to assess sexual function. It contains ten items covering five domains of female sexual function: desire and interest, foreplay, excitement and harmony, comfort, and orgasm and satisfaction. Higher QS-F scores indicate better sexual functioning. RESULTS: There was a significant increase in the mean total QS-F score after surgery in both groups (p < 0.001). No significant improvement in desire and comfort was reported by patients who underwent breast augmentation and in comfort by patients who underwent breast reduction. Improvement in sexuality after surgery was observed in both groups, which is consistent with the literature. CONCLUSION: Aesthetic breast surgery has a positive impact on the sexuality of patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.