Response to "The Value of Two-Dimensional Analysis of Changes in Breast Shape".

Abstract

We read the letter by Dr. Swanson,1 in which he refers to the two-dimensional system for the evaluation of augmented breasts we described,2 with considerable interest. This system is useful as a means of keeping a visual record of patients' data and of evaluating changes in size over time, though it does require the ability to use computer programs and it is somewhat time-consuming. The pros and cons of one-dimensional systems have instead been extensively described in the literature, as Swanson remarked in his letter. We have several concerns regarding his claims and conclusions. We agree that the distance from the suprasternal notch to the nipple is affected by the length of the torso and that this distance is not related to breast aesthetics. We also agree that the nipple level is not altered appreciably after a bilateral symmetric breast augmentation. It can, however, change markedly when asymmetric breasts are corrected with implants of different sizes, especially when implants are combined with some forms of mastopexy. In such cases, the afore-mentioned distance, and consequently the system we described, may prove useful for an objective evaluation of the degree of …