Breast Size Research Articles

Numerical and experimental analysis of the ballistic performance of soft bulletproof vests for women

Abstract This article presents a comprehensive numerical and experimental analysis of the ballistic performance of soft bulletproof vests designed for women. The study involved a woman aged between 24 and 28 with a breast size of 85C. Two ballistic packages made from Twaron® CT 709 fabric were designed and constructed for her, featuring cut-and-sew formed breast cups and differing significantly in the number of layers (16 and 30 layers). The impact of the number of layers on breast deformation during the shooting was analyzed using numerical modeling and experiments, which included a Parabellum 9 mm × 19 mm FMJ® bullet and a Roma No. 1 plasticine substrate formed based on a plaster cast representing a woman’s figure. The research found that even significantly increasing the number of layers in the ballistic package did not lead to a substantial reduction in breast deformation during shooting. The likely reason for this is the cut-and-sew formed breast cups in the ballistic package, which easily undergo transverse deformation upon bullet impact. This suggests a need for further research to optimize the design of protective cups, which are crucial for proper force distribution and minimizing injuries during bullet impact. The conclusions drawn from this study could contribute to the development of more advanced and effective soft ballistic protection solutions for women.

Understanding Variation in Bra Cup Sizing Among Leading Manufacturers: A Current Guide for Patients and Surgeons.

Brassiere (bra) size is commonly used when patients and plastic surgeons discuss breast procedures. Variations in sizing between manufacturers can affect patient-surgeon communication and postoperative satisfaction. This study quantifies bra cup volume across alphanumeric sizes and manufacturers to describe variance and improve preoperative communication for shared decision-making. Bras sized 36A-DD from seven manufacturers were fit to a mannequin and filled using custom breast sizers. Sizers were weighed and converted to volume, and statistical differences in cup volume between manufacturers were assessed at each size. Cup volume varied significantly between manufacturers at all sizes, with larger cup sizes showing greater variance. Standard deviation in mean cup volume (cc), across all manufacturers, was A: 30.9, B: 40.1, C: 62.2, D: 69.7, and DD: 122.8. Calvin Klein and Hanes ran small, while Wacoal ran larger at sizes C-DD. Wacoal was significantly larger than Hanes and Calvin Klein at sizes 36C (P < 0.05 and P < 0.01) and 36D (P < 0.05 and P < 0.005), and was significantly larger than Calvin Klein at 36DD (P < 0.005). Variation was observed at cup sizes A and B, though individual manufacturer trends were less clear. Soma was significantly larger than Victoria's Secret at size 36A (P < 0.005), and Victoria's Secret was significantly larger than Calvin Klein at 36B (P < 0.05). This study provides a reference for surgeons and patients when discussing goal breast size after procedures. These data are especially useful for larger cup sizes, where variation in cup volume is greatest, enabling more accurate communication and greater patient understanding. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

Streamlining outpatient prepectoral breast reconstruction: The role of polyurethane oxygen-enriched bra cups from pandemic innovation to standardized cost analysis

Background: The COVID-19 pandemic necessitated a reassessment of healthcare delivery, emphasizing on strategies to reduce hospital visits without compromising patient care. In response, plastic surgery units explored innovative approaches to ensure high-quality care and enhanced protection for vulnerable groups, such as oncologic patients undergoing mastectomy and breast reconstruction. This study evaluates the implementation of a polyurethane-polyester bra cup enriched with oxygen to diminish the need for postoperative outpatient visits. Methods: Patients who underwent mastectomy and prepectoral breast reconstruction between February 2020 and March 2021 were selected. A novel postoperative management protocol with a polyurethane-polyester bra cup was adopted, and a cost-benefit analysis evaluated the economic impact of integrating this medical device into postoperative care. Results: The polyurethane-polyester bra cup wound dressing significantly reduced the frequency of outpatient visits, enhancing patient autonomy in postoperative care. Patients reported high satisfaction levels, particularly appreciating the ability to manage the device independently, which contributed to the substantial reduction of hospital accesses. Economic analysis revealed that the devices’ utilized resulted in a notable reduction of 333.5 working hours, translating to a financial saving, ranging between €9990 and €40,020 for nursing and medical staff, respectively. The device cost was established at €20 per unit, demonstrating an effective cost-saving strategy in postoperative care. Conclusions: The adoption of polyurethane-polyester bra cup in postsurgical care for mastectomy patients undergoing implant-based prepectoral breast reconstruction proved to be a strategic measure in reducing hospital visits and maintaining high levels of patient satisfaction.

The effect of female breast surface area on cutaneous thermal sensation, wetness perception and epidermal properties.

Female development includes significant size changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast sensitivity to warm, cold and wetness, and the associated epidermal properties (skin thickness and surface roughness) remain unclear. We investigated the relationship between BrSA and thermal and wetness perception, as well as epidermal properties, in 21 females (28 10 years) of varying breast sizes (BrSA range: 147-502cm2), at multiple breast sites (i.e., nipple, above and below the nipple, and bra triangle). Associations between BrSA and the perceptual and epidermal variables were determined via correlation analyses. Differences across test sites were assessed by repeated-measures ANOVA. Our results did not support the hypothesis that larger breasts present reduced thermal and wetness sensitivity, except for the above nipple site, which presented reduced warm sensitivity with increasing BrSA (r=-0.61, P=0.003). We also found a heterogeneous distribution of cold, but not warm or wetness, sensitivity across the breast, with the above nipple site presenting lower cold sensitivity than any other site (P<0.015). Our findings did not indicate any association between BrSA and epidermal properties (thickness and roughness), nor any site-dependent variation in these anatomical parameters (P>0.15). We conclude that, while some skin-site (i.e., above the nipple) and perceptual modality-dependent (i.e., warm sensitivity) differences were observed, BrSA-dependent variations in thermal and wetness sensitivity were not a generalised feature of the skin covering the breast. These observations advance our fundamental understanding of breast sensory function, and they could inform the design of user-centred clothing such as bras.

Breast size, thoracic kyphosis, and thoracic spine pain: a correlational survey of Nigerian postpartum mothers.

Thoracic spine postural dysfunctions are common postpartum-related health problems, compromising breastfeeding efficacy and quality of life among women. Previous studies have particularly associated these conditions with increased breast sizes in several populations. However, such empirical evidence is scarce in the Nigerian population. To investigate the relationship among breast size, thoracic-kyphosis, and -spine pain among postpartum Nigerian women. This correlational survey involved 400 consenting postpartum mothers (between 0 and 24 months of postpartum period). Their breast size, thoracic spine posture, and pain were measured using a measuring tape (cm), inclinometer, and Revised Oswestry thoracic spine pain disability questionnaire, respectively. Data were analyzed using descriptive and relevant inferential statistics at p < 0.05. The majority of the participants fall under the category of breast cup size B (61.75%), have no history of thoracic spine pain (87.4%), and about half of them (50.2%) have normal thoracic spine posture (low category with values ranging between 20⁰ and 35⁰. Breast size was significantly (r = 0.162, p = 0.001) correlated with thoracic spine posture but showed no significant correlation (r = 0.066, p = 0.622) with thoracic spine pain. Increasing breast size is weakly associated with a tendency towards a kyphotic posture of the thoracic spine. Postural education and care around adequate support of the breast with suitable fitting brassieres may help prevent kyphotic deformities. Future research with a randomized control trial and long-term follow-up is recommended to further confirm the causal relationship of these variables.

Correlation of weight and volume of modified radical mastectomy specimen with ptosis of breast in patients of breast cancer

BackgroundPreoperative assessment of breast features is indispensable for both cosmetic and reconstructive breast surgical procedures. In this study we aim to investigate the effect of breast ptosis on breast volume estimation by various methods. MethodsFifty patients of breast cancer planned for modified radical mastectomy were taken up. Preoperatively breast anthropometric measurement taken, grade of ptosis was noted and breast volume was calculated by anthropometry and mammography and intraopratively mastectomy specimen weight and volume was recorded. Breast volume calculated by mammography and anthropometry compared with mastectomy specimen volume and weight and correlation with ptosis was statistically analyzed. ResultsMastectomy specimen volume showed best agreement with mastectomy specimen weight (r ​= ​.993, <.001), followed by mammographic method (r ​= ​.985, P ​< ​.001), anthropometry by breast circumference in supine method (r ​= ​.982, P ​< ​.001), anthropometry by breast circumference in upright method (r ​= ​.979, P ​< ​.001) and anthropometry by breast radius and mammary projection method (r ​= ​.969, P ​< ​.001). ConclusionMammography is simple, cost effective and most accurate method for breast volume estimation followed by anthropometric breast volume calculation. As size of breast and grade of breast ptosis increases the accuracy of all methods of breast volume estimation decreases.

Improving breast-cancer diagnostics: A study using AI-ML with computational prognostics and feature extraction

: Though and even though advancements are high during last two decades, yet ‘breast—cancer’ continues to be a sizable causal transience amongst females (womankind) globally. Whilst mammography has distinctly lowered death rates, detection and categorization and accuracy of breast sizes (forms in quantities) in mammograms remains argue. Thus we present a new method of detection and discovery of key region-of-interest(ROI) plus its labeling as natural usual ‘0’, benign ‘1’, or cancerous ‘2’ sizes. : For sorting of identified ‘ROIs’ as usual, benign or malicious exactly. : We use the removal of temporally sequential digital mammograms, merged via machine-learning (ML). We estimated feature-selection algorithmic techniques (ATs) over the novel database (data—set) comprises images~circa352 as of 88 diseased exactly noted by sites-of-mass. 98 feature extractions were done and classified by 8 dissimilar feature-selection ATs to detect the best discriminative features. We then computed 10classifiers via first in first out (FIFO) diseased plus a k-fold cross validation. In our computation, we observed the artificial neural nets (ANNs) appeared as the highest classifier with 99.5%accuracy, 0.98AUC (for label ‘0’), 0.92AUC (for label ‘1’, plus 0.94AUC (for class ‘2’). : Our findings showed significant progress in divergence (disparity) through existing advanced high-tech algorithms and techniques, which feature worth of using temporally successive mammographs in amalgamation, with advanced computational intelligence ML, aimed at the exact sorting of identified ‘ROIs’ as usual, benign or malicious. : Clinical significancy/ when clinically applied, this study improves the clinical prognosis precision of breast-cancer possibly steering to reliable diseased outcomes plus added personalized therapeutic attempts.

Exploring bilateral breast size and density asymmetry: Insights from the saudi screening population

Background/objectivesThe swift appearance of asymmetry in breast size and density has been associated with an increased risk of breast cancer and other pathological changes. However, the occurrence of breast asymmetry and the factors influencing it have not been extensively studied among healthy, screened women in the Saudi population. Thus, this study aims to explore bilateral breast asymmetry in breast size and density among healthy, screened Saudi women and factors affecting the asymmetry. MethodsData of 1048 out of 1173 eligible women screened between 2012 and 2018 were extracted from Sheikh Mohammed Hussien AL-Amoudi Center of Excellence in Breast Cancer. The Laboratory for Individualized Radiodensity Assessment (LIBRA) software was used to measure percent density, dense area, and total area of breast from mammograms. Paired t-test was used to examine asymmetry between right and left breasts, and stratified analysis was performed to investigate the factors associated with breast asymmetry. ResultsNo significant differences were observed between the right and left breasts in percent density, dense area, and total breast area (p ≥ 0.2). However, for participants who never breastfed, the right breast area was slightly larger (average: 207.9 cm2) than the left breast (average: 202.8 cm2); p = 0.008. ConclusionThere were no significant differences found in the density, and size of the right and left breasts. However, women who breastfed tended to have slightly larger right breasts.

Evaluation of three acetabular measurement methods for total hip replacement in dogs.

To compare three measurement methods for acetabular sizing and evaluate the influence of osteoarthritis (OA) on the accuracy of measurements. Observational study. Radiographic images of 73 hip joints from 60 dogs with cementless cups. Radiographs were anonymized and measured independently by three observers. One observer measured 12 sets of radiographs three times. A best-fit acetabular circle (AC) and cranial-caudal acetabular line (AL) were measured on ventral-dorsal (VD) radiographic view and open leg lateral (OLL) view. A best-fit femoral head circle (FHC) was measured on VD, OLL, and craniocaudal horizontal beam (CCHB) views. Two observers scored the OA in each hip joint. Intra- and interobserver consistency and repeatability and bias relative to implanted cup size were calculated and analyzed. Intraobserver consistency and repeatability were excellent for all measurements. Interobserver consistency was excellent (ICC > 0.9) for ACVD and ACOLL and was good (0.75 < ICC ≤ 0.9) for all other methods. Bias was small for AC and AL measurements (range, -0.46 to 0.45 mm) and large for FHC measurements (-3.58 to -2.42 mm). OA score significantly influenced bias for all acetabular measurement methods (p < 0.05). All acetabular measurement methods were highly consistent within an observer. Interobserver consistency was highest for ACVD and ACOLL. FHC measurements underestimated cup size. Higher OA scores decreased the accuracy of all acetabular measurement methods. Superimposing a circle on the acetabulum seen on VD radiographic view accurately measures the acetabulum before cementless cup placement.

The accuracy and efficiency of design and development of 3D printed integral anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip

Objective: To compare the accuracy and efficiency between the model development method and the software development method, which design and develop 3D printed integral anatomical acetabular prosthesis to be used in total hip arthroplasty(THA) for patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH). Methods: Fifteen patients with end-stage hip osteoarthritis due to Crowe type Ⅱ and Ⅲ DDH who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Bengbu Medical College between January 2015 and June 2023 were selected in this study retrospectively. There were 1 male (1 hip) and 14 females (17 hips) with a mean age of (55.1±9.1) years. There were 12 hips with Crowe type Ⅱ, 6 hips with Crowe type Ⅲ. The preoperative pelvis three-dimensional CT data in those patients were used to design integral anatomical acetabular prosthesis. The model development group used 3D printing technology to print life-size pelvis models. The acetabulum was reamed and the acetabulum cup was inserted into the socket according to conventional THA procedures. The bone defect above the acetabulum cup was filled with bone wax. The Mimics and 3-matic software were used to simulate the THA procedures, design and install the integrated anatomical acetabular prosthesis in the software development group. The operation time, the size of the acetabular cup, the volume and surface area of the acetabulum bone defect, the acetabular cup's inclination and anteversion, the horizontal distance and the vertical distance of hip rotation center were compared between the two methods. Results: The study in the two groups were all based on the data of 18 hips in the 15 patients. The horizontal and vertical distances of rotation center in the model development group and software development group was (32.08±1.80) mm, (32.17±2.40) mm and (14.36±1.53) mm, (15.11±1.45) mm, respectively (both P>0.05). The cup size in model development group was (48.56±1.15)mm, and it was (48.77±1.22) mm in the software group (P=0.160). The anteversion and inclination of the acetabular cup in the model and software groups were 23.79°±6.31°, 30.49°±11.03° and 15.17°±0.52°, 40.24°±0.58°, respectively (both P<0.01). The volume and surface area of the acetabulum bone defect in the model development group was (5.06±2.86) mm3 and (8.31±2.21) mm2, respectively, while it was (4.01±2.56)mm3 and (6.83±2.71) mm2, respectively, in the software development group (both P<0.05). The work time in the model development group was (24.43±0.68) h and (0.47±0.12) h in the software development group, respectively (P<0.001). Conclusion: Compared with the 3D printing model development method, the application of Mimics and 3-matic software to design and develop integrated anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ DDH show advantages of convenience, high efficiency and more accuracy.

A Novel Breast-Volume Self-Measurement Method with Improved Convenient and Accuracy

Breast volume is crucial for ensuring proper bra fit and comfort, significantly influencing women’s physiological and psychological well-being. This study aims to develop a novel method for breast-volume self-measurement, allowing women to accurately assess their breast volume without specialized equipment. We employed a geometric approximation of the breast as a combination of a partial elliptical cone and an irregular partial ellipsoid, leading to the formulation of a new volume equation. The method was validated against established standards, including the specimen drainage method and 3D scanning techniques. The findings revealed that our self-measurement approach achieved a relative error of only 3.8%, outperforming the 4.8% of 3D scanning and the 86.3% associated with traditional breast-volume equations. This innovative self-measurement technique enhances accuracy and serves as a practical solution for health and nutritional assessments, alongside body image evaluations. Its user-friendly nature positions it as a valuable tool for women’s health, particularly in personal fitness and ergonomic design.

Premature Thelarche: An Updated Review.

Premature thelarche is the most common pubertal disorder in girls. The condition should be differentiated from central precocious puberty which may result in early epiphyseal fusion and reduced adult height, necessitating treatment. The purpose of this article is to familiarize physicians with the clinical manifestations of premature thelarche and laboratory tests that may help distinguish premature thelarche from central precocious puberty. A search was conducted in September 2022 in PubMed Clinical Queries using the key term "Premature thelarche". The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used to compile the present article. Premature thelarche denotes isolated breast development before the age of 8 years in girls who do not manifest other signs of pubertal development. The condition is especially prevalent during the first two years of life. The majority of cases of premature thelarche are idiopathic. The condition may result from an unsuppressed hypothalamic-pituitary-gonadal axis in the early years of life, an "overactivation" of the hypothalamic-pituitary axis in early childhood secondary to altered sensitivity to steroids of the hypothalamic receptors controlling sexual maturation, increased circulating free estradiol, increased sensitivity of breast tissue to estrogens, and exposure to exogenous estrogens. The cardinal feature of premature thelarche is breast development which occurs without additional signs of pubertal development in girls under 8 years of age. The enlargement may involve only one breast, both breasts asymmetrically, or both breasts symmetrically. The breast size may fluctuate cyclically. The enlarged breast tissue may be transiently tender. There should be no significant changes in the nipples or areolae and no pubic or axillary hair. The vulva, labia majora, labia minora, and vagina remain prepubertal. Affected girls have a childlike body habitus and do not have mature contours. They are of average height and weight. Growth and osseous maturation, the onset of puberty and menarche, and the pattern of adolescent sexual development remain normal. Most cases of premature thelarche can be diagnosed on clinical grounds. Laboratory tests are seldom indicated. No single test can reliably differentiate premature thelarche from precocious puberty. Premature thelarche is benign, and no therapy is necessary apart from parental reassurance. As enlargement of breasts may be the first sign of central precocious puberty, a prolonged follow- up period every 3 to 6 months with close monitoring of other pubertal events and linear growth is indicated in all instances.

Enhanced Diabetic Retinopathy Detection Using U-Shaped Network and Capsule Network-Driven Deep Learning

Glaucoma, a severe eye disease leading to irreversible vision loss if untreated, remains a significant challenge in healthcare due to the complexity of its detection. Traditional methods rely on clinical examinations of fundus images, assessing features like optic cup and disc sizes, rim thickness, and other ocular deformities. Recent advancements in artificial intelligence have introduced new opportunities for enhancing glaucoma detection. This research explores a hybrid approach combining UNet++ and Capsule Network (CapsNet) architectures for accurate glaucoma diagnosis. UNet++ is employed for semantic segmentation, focusing on defining optic discs and cups, which are crucial for detecting the disease. CapsNet leverages its ability to recognize hierarchical patterns, providing more sensitive detection of glaucomatous changes than conventional Convolutional Neural Networks. Pre-processing of retinal images involves advanced techniques like Histogram Equalization and Contrast Limited Adaptive Histogram Equalization (CLAHE) to enhance image quality. The model is trained and tested on benchmark datasets, showing superior performance in optic cup/disc segmentation and glaucoma detection accuracy compared to existing state-of-the-art models.• Hybrid Model Efficiency: The combined use of UNet++ and CapsNet offers improved accuracy in optic cup and disc segmentation.• Enhanced Image Quality: Application of Histogram Equalization and CLAHE techniques significantly boosts the quality of retinal images.• Superior Performance: The hybrid approach outperforms traditional and contemporary models in glaucoma detection accuracy.

“Comparison of DIEP and PAP free flaps for breast reconstruction in the context of breast cancer: A retrospective study of 677 patients over 10 years”

BackgroundPAP (Profunda Artery Perforator) flap following cancer surgery has emerged as a relevant alternative for breast reconstruction but remains mainly used in cases where the DIEP (Deep Inferior Epigastric Perforator) flap cannot be performed. The aim of this work is to compare PAP and DIEP flaps’ surgical and aesthetics outcomes in breast reconstruction. MethodsWomen who underwent breast reconstruction by DIEP or PAP flap at the Plastic Surgery Department of Georges Pompidou European University Hospital, Paris, France, between January 2012 and December 2020 were included. Patient’s demographic characteristics were recorded as well as type, laterality and timing of reconstruction. Operative times, length of hospital stay, general and surgical complications were compared. The number of late surgical reoperations, their timing relative to the initial reconstructive procedure, and their purpose were also compared. ResultsA total of 677 patients were included, 559 of whom received a DIEP flap and 118 a PAP flap. PAP flap patients were significantly younger, thinner, and had a smaller initial bra cup size than those who received a DIEP (p<0.001) Operative time was similar for both groups (p=0.074). There was no difference in the number of early postoperative reoperations (p>0.554) or of late revisions (p>0.403) between DIEP or PAP. ConclusionProvided that the technical and human resources are available, PAP flap is a valid technique, with no increased risk of surgical complications and reoperations, nor lengthening of operative time. The PAP flap should be considered a primary therapeutic option and not only an alternative to the DIEP flap.

How does the position of the pelvis and femur influence the selection of prosthesis size during 2D preoperative planning for total hip arthroplasty?

PurposeTotal Hip Arthroplasty (THA) is the primary treatment for hip diseases today. Nevertheless, total hip arthroplasty has its challenges, and one of these challenges is the potential for incorrect execution of the preoperative planning process. Such errors can lead to complications such as loosening and instability of the prosthesis and leg length discrepancy. In this study, we used human phantoms to investigate the influence of pelvic and femoral factors on prosthesis size selection in the preoperative planning of total hip arthroplasty and to provide a reference standard for clinical imaging in preoperative planning of total hip arthroplasty.MethodsIn this experiment, we utilised a custom-made experimental device that enabled us to manipulate the movement of the pelvis and femur in various directions. The device also incorporated sensors to control the angle of movement. By obtaining X-rays from different positions and angles, we were able to determine the size of the prosthesis based on the 2D preoperative planning generated by the mediCAD software.ResultsWhen the pelvis was in a nonneutral position, the size of the acetabular cup varied within a range of three sizes. Similarly, when the femur was in a nonneutral position, the size of the femoral stem varied within a range of two sizes. The movement of the pelvis and femur in the coronal plane, relative to the neutral position, did not impact the selection of the prosthesis size. However, the motion of the pelvis and femur in the sagittal and transverse planes had a notable effect.ConclusionThe selection of the prosthesis size for preoperative planning can be significantly influenced by specific positions of the pelvis and femur. It is crucial for the radiographer to ensure that the pelvis and femur maintain a standard neutral position, particularly in the sagittal and transverse planes, during the image acquisition process.

Staged Nipple Delay Procedure Expands Candidacy for Nipple-Sparing Mastectomy.

Nipple delay (ND) is a staged procedure that improves nipple-areolar complex (NAC) viability in nipple-sparing mastectomy (NSM) patients who are high-risk for NAC or skin-flap necrosis. This study compared postoperative outcomes and risk factors between patients treated with ND-NSM and NSM alone. Patient demographics, risk factors for NAC or skin-flap necrosis, tumor characteristics, and operative outcomes were compared between ND-NSM and NSM groups from 2009 to 2023. Univariate and multivariate analyses were performed to identify significant variables associated with NAC or skin-flap necrosis. Overall, 71 ND-NSM patients and 537 NSM patients were compared. ND-NSM patients had larger breasts (p<0.01), body mass index ≥ 30 (p=0.01), prior breast/chest wall radiation (XRT) [p<0.01], prior breast operations (p<0.01), less axillary surgery (p<0.01), more autologous tissue reconstruction over implant-based reconstruction compared with NSM patients (p=0.02), and more prophylaxis (p<0.01). There were no statistically significant differences between groups in regard to infection, skin-flap necrosis, NAC necrosis, seromas, and hematomas. No patients in the ND-NSM group had NAC necrosis and 1 patient had skin-flap necrosis, compared with 17 and 13 patients in the NSM group, respectively (p=0.24). On univariate analysis, prior XRT was associated with increased risk for skin-flap necrosis (p=0.02). Multivariate analysis showed XRT was associated with skin-flap necrosis (p=0.02) and any necrosis (p=0.01). Breast size was associated with NAC or skin-flap necrosis (p=0.04). Larger breasts and XRT were risk factors for NAC or skin-flap necrosis; however, despite having more risk factors, ND-NSM patients had very low rates of necrosis. Notably, no nipples were lost. A shared decision should be made with patients regarding the risks and benefits of ND-NSM.

Are some neutral liners more neutral than others? An ex vivo morphological analysis of acetabular liners classified as "neutral".

In contemporary total hip replacement (THR), dislocation is one of the most common complications. At our institution, the cause of an increase in the dislocation rate was recently reported to be reduced head coverage of a newly introduced neutral liner. We therefore aimed to ascertain whether differences exist in articulating head coverage between the various neutral liners used in contemporary THR. A secondary aim was to utilize coverage measurements to develop a new liner coverage classification. The articulating head coverage of 25 modular neutral polyethylene liners used in 6 uncemented cup designs from 4 major manufacturers was evaluated. The measurements were performed in a metrology laboratory and a mathematical model was developed to calculate coverage of the articulating surfaces. Further, 1 "elevated rim" liner and 1 "face changing liner" were included to develop a new liner coverage classification. The articulating head coverage among the studied liners ranged from 167.7° to 194.8°, corresponding to a variation of 27.1°. The variations with different cup and head sizes within each design were smaller (from 1.0° to 5.6°) than those between different designs. Each of the liner designs offered distinct coverage, even though they were all classified as neutral. Based on measurements, a set of descriptive parameters to discriminate different liners in terms of coverage was created. We showed that all neutral liners are not equal - instead, they clearly varied in terms of their actual coverage design. We suggest our set of descriptive parameters called "hemispheric coverage index values" be used in discriminating the differences in liner coverage.

7467 Supplement Use Among Transgender Patients: Case Reports and Literature Review

Abstract Disclosure: H. Cunningham: None. Q. Jones: None. C. Kelley: None. The barriers to initiating gender affirming medical treatment are innumerable and increasing in the wake of wide-sweeping anti-trans legislation, leading many transgender individuals to utilize more accessible means of transitioning. We provide examples of patient-initiated supplement use at a gender medicine clinic in the Southeast. We describe a 60-year-old transgender woman who was unable to establish care due to lack of affirming providers in her region and insurance approval delays. She began taking Pueraria mirifica, along with saw palmetto and fenugreek, for feminization. Subsequently, her breast size increased from an A to B cup, and she noticed fat redistribution to her hips. When finally seen one year later, labs demonstrated suppressed luteinizing and follicle stimulating hormones and increased sex hormone binding globulin, with an associated decrease in estradiol and testosterone levels. Cessation of supplements resulted in lab normalization. Our second case describes masculinizing effects, including voice deepening, experienced by a transgender man using a supplement that contained "orchic extract.” Supplements used for gender affirmation can also have more adverse effects, including polycythemia in the setting of trenbolone, an illicit steroidogenic performance enhancing supplement used for masculinization by some patients assigned female at birth. Patients without access to gender affirming hormones through a medical provider, or who do not feel comfortable accessing health care, may be more likely to use supplements purchased online without a prescription. Considering this, we must create more safe spaces for gender affirming care and ask all transgender patients about supplement use. Providers should consider supplement use as a possible explanation for unexpected lab results. The literature on supplement use for gender-affirming effects is sparse; this presentation provides a summary of and contributes to the current literature on this topic. Presentation: 6/2/2024

Perceived knowledge of sports bras and bra fit in Australian Women’s Rugby union

Perceived knowledge of sports bras and bra fit in Australian Women’s Rugby union

The effect of female breast surface area on skin stiffness and tactile sensitivity at rest and following exercise in the heat.

Female development includes significant morphological changes across the breast. Yet, whether differences in breast surface area (BrSA) modify breast skin stiffness and tactile sensitivity at rest and after exercise in the heat remain unclear. We investigated the relationship between BrSA and skin stiffness and tactile sensitivity in 20 young to middle-aged women (27±8years of age) of varying breast sizes (BrSA range: 147-502cm2) at rest and after a submaximal run in a warm climatic chamber (32 ± 53%±1.7% relative humidity). Skin stiffness above and below the nipple and tactile sensitivity from the nipple down were measured. Associations between BrSA and both skin stiffness and tactile sensitivity at rest were determined via correlation analyses. Effects of exercise and test site were assessed by a two-way ANOVA. Skin stiffness was positively correlated with BrSA 3cm above the areola edge (r=0.61, P=0.005) and at the superior areola border (r=0.54, P=0.016), but not below the nipple (P>0.05). The area 3cm below the areola was also significantly stiffer than all other test sites (P<0.043). Tactile sensitivity did not vary with BrSA (P>0.09), but it varied across the breast (i.e., the area 3cm below the areola was more sensitive than the inferior areola edge; P=0.018). Skin stiffness and tactile sensitivity across the breast decreased after exercise by ∼37% (P<0.001) and ∼45% (P=0.008), respectively. These findings expand our fundamental understanding of the mechanosensory properties of the female breast, and they could help to inform sportswear innovation to better meet the support needs of women of different breast sizes at rest and following exercise.