The rule of thirds: Determining the ideal areolar proportions

Matthew J. Laschuk,Howard J. Silverman,Grayson A. Roumeliotis,Lisa Xuan,Linden K. Head

doi:10.1016/j.jpra.2019.11.001

Matthew J. Laschuk, Howard J. Silverman + Show 3 more

Open Access

https://doi.org/10.1016/j.jpra.2019.11.001

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Journal: JPRAS Open	Publication Date: Nov 13, 2019
Citations: 4	License type: cc-by

Affiliation: University of Ottawa, University of Oxford

Abstract

BackgroundBreast surgery often requires changing the diameter of the areola. Recommended areolar size is commonly based on population averages, or surgical judgement. An ideal areola size has not been previously been described. We hypothesized that the ideal areolar diameter would be proportional to two breast measurements not commonly altered during breast surgery: the nipple diameter and breast base width. Methods‘The Sun’ newspaper (London, UK) publishes photographs of topless models which are selected based on the aesthetic appeal of their non-operated breasts. The publication's archive, from March 2014 to January 2017, was independently reviewed by three authors to identify photographs that presented a clear anterior view of the breast. The base width, nipple diameter and areolar diameter were measured independently by each reviewer. Measurements were pooled, and the mean was included for analysis. Ratios of the areolar diameter to the base width and the nipple diameter were calculated. ResultsThe photographs of 58 models were eligible for inclusion. The average areolar diameter to base width was 0.29 (SD = 0.05). The average nipple to areolar diameter was 0.29 (SD = 0.06). ConclusionsIn aesthetically pleasing breasts, the areolar diameter is proportional to both the breast base width and nipple diameter. Breast base width is commonly measured preoperatively in aesthetic breast procedures, and is not typically modified. Breast base width can therefore be used to determine the ideal areolar size using the ratio of areola:base width ratio of 0.29 identified in this study.

Highlights

Ideal breast aesthetics are quantified by several different metrics:[1] Optimal breast volume, shape, nipple angulation,[2,3] and breast parenchymal distribution[2,3] have been defined
In surgical procedures in which the size of the nipple areolar complex will be altered, a final diameter of 35–45 mm is typically recommended.[4]
The typical ratio of the diameter of the nipple areolar complex to base width has been described as 1:3.5 these reference values are based on normative data and describe population averages rather than aesthetically ideal breasts.[4,5]

Summary

Introduction

Ideal breast aesthetics are quantified by several different metrics:[1] Optimal breast volume, shape, nipple angulation,[2,3] and breast parenchymal distribution[2,3] have been defined. Malluci and Branford[2,3] applied a novel method to develop their widely accepted rule of vertical proportion of parenchymal distribution relative to the nipple meridian, and measured these variables in models who had been independently selected largely for the appearance of their non-operated breasts.[2,3,6] We hypothesized that the aesthetically ideal diameter of the nipple areolar complex would be different from previous estimates based on population averages and would vary with breast base width. We hypothesized that the ideal areolar diameter would be proportional to two breast measurements not commonly altered during breast surgery: the nipple diameter and breast base width.

Methods

Discussion

Conclusion