Leawood, Kan. From private practice.
Plast Reconstr Surg. 2012 Apr;129(4):982-992. doi: 10.1097/PRS.0b013e3182442290.
Evaluation of changes in breast shape, particularly "upper pole fullness," "breast projection," and "bottoming out," has been made difficult by the lack of an accepted definition of these entities and no standardized system for measurements and comparison. Three-dimensional imaging is impractical for most surgeons and limited in providing evidence-based assessments.
Using standardized photographs and computer imaging software to match size and orientation, breast shape and size are measured and compared before and after cosmetic breast surgery. Practical landmarks and analysis allow assessment of results using standard two-dimensional frontal and lateral views. A horizontal plane at the level of maximum postoperative breast projection and a vertical plane dropped from the sternal notch serve as the reference planes. Breast projection, upper pole projection, lower pole level, nipple level, lower pole width, breast parenchymal ratio, and lower pole ratio (a measure of the boxiness of the lower pole) are defined and measured.
These simple measurements may be easily used by surgeons to evaluate the effectiveness of their techniques in breast augmentation, mastopexy, augmentation/mastopexy, and reduction. Claims regarding changes in breast projection, upper pole projection, and breast mound elevation may be objectively evaluated.
This measurement system provides a highly practical means with which to quantitate breast shape changes after surgery and assess surgical results using well-defined references.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
由于缺乏对这些实体的公认定义，也没有标准化的测量和比较系统，因此评估乳房形状的变化，特别是“上部饱满度”、“乳房突出度”和“底部凹陷”变得困难。对于大多数外科医生来说，三维成像不切实际，并且在提供基于证据的评估方面受到限制。
使用标准化的照片和计算机成像软件来匹配大小和方向，对美容乳房手术后的乳房形状和大小进行测量和比较。实用的地标和分析允许使用标准的二维正面和侧面视图评估结果。在最大术后乳房突出水平的水平平面和从胸骨切迹下降的垂直平面用作参考平面。乳房突出度、上部突出度、下部水平、乳头水平、下部宽度、乳房实质比和下部比（衡量下部的方形度）定义和测量。
这些简单的测量值可以很容易地被外科医生用于评估他们在乳房增大、乳房提升、增大/乳房提升和缩小手术中的技术效果。可以客观评估关于乳房突出度、上部突出度和乳房隆起高度变化的说法。
该测量系统提供了一种非常实用的方法，可以量化手术后乳房形状的变化，并使用定义明确的参考来评估手术结果。
临床问题/证据水平：治疗，V。
