Hudson Donald A, Lelala Ngoato B
Department of Plastic and Reconstructive Surgery, University of Cape Town, Cape Town, South Africa.
Plast Reconstr Surg Glob Open. 2019 May 24;7(5):e2150. doi: 10.1097/GOX.0000000000002150. eCollection 2019 May.
The anthropomometry of the "ideal" breast is well described, but changes that occur with enlarged breasts are not. The aim of this study was to assess the prevalence of nipple asymmetry in the horizontal plane and changes in the inframammary fold (IMF) in patients presenting with macromastia (defined as excessive development of the mammary glands by Merriam-Webster dictionary).
One hundred patients (200 breasts) presenting to the Plastic Surgery Clinic for bilateral breast reduction were enrolled in this study. Patients' characteristics captured for this study included age, body mass index (BMI), and breast anthropometric measurements, such as suprasternal notch to nipple, nipple to IMF, IMF projected to cubital fossa, midhumeral point, and nipple measurement from meridian. Basic univariate statistical analyses were performed to evaluate the impact of nipple asymmetry.
The average age was 37 years (SD 12 years), and the median BMI was 33 (IQR 28-37). More patients presented with nipple asymmetry, of whom 45% were classified as lateral to the meridian, 19% were classified as medial to the meridian, and 36% were classified as central to the meridian. Patients with lateral asymmetry and medial asymmetry had a significantly higher BMI (median BMI 35) compared with patients with central positioning (median BMI 30). Increasing breast size was positively associated with nipple asymmetry, whereas BMI ( = -0.30, = 0.003) and macromastia correlated negatively with IMF position ( = -0.38, = 0.0001).
In macromastia, nipple displacement from the breast meridian, especially lateral displacement, is common and is aggravated by an increase in BMI. The IMF also descends, and this is also more common in patients with a raised BMI. These changes have clinical implications.
“理想”乳房的人体测量学特征已有详尽描述，但乳房增大时发生的变化却未被充分研究。本研究旨在评估巨乳症患者（根据韦氏词典定义为乳腺过度发育）乳头在水平面上的不对称发生率以及乳房下皱襞（IMF）的变化情况。
本研究纳入了100例到整形外科门诊接受双侧乳房缩小术的患者（200个乳房）。本研究收集的患者特征包括年龄、体重指数（BMI）以及乳房人体测量数据，如胸骨上切迹至乳头的距离、乳头至IMF的距离、IMF至肘窝的投影距离、肱骨中点以及乳头子午线测量值。进行了基本的单变量统计分析以评估乳头不对称的影响。
平均年龄为37岁（标准差12岁），BMI中位数为33（四分位间距28 - 37）。更多患者存在乳头不对称，其中45%被归类为子午线外侧，19%被归类为子午线内侧，36%被归类为子午线中央。与处于中央位置的患者（BMI中位数30）相比，外侧不对称和内侧不对称的患者BMI显著更高（BMI中位数35）。乳房尺寸增大与乳头不对称呈正相关，而BMI（r = -0.30，P = 0.003）和巨乳症与IMF位置呈负相关（r = -0.38，P = 0.0001）。
在巨乳症中，乳头偏离乳房子午线，尤其是外侧移位很常见，且会因BMI升高而加重。IMF也会下降，这在BMI较高 的患者中也更常见。这些变化具有临床意义。
