Predicting "Ideal" Breast Proportionality to Support Implant Selection in Breast Augmentation.

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Biomechanical Engineering

Background:

• The 45:55 upper-to-lower pole breast proportion is a key aesthetic goal in breast augmentation.
• Preoperative prediction of achieving this proportion is challenging due to factors beyond implant volume, including implant geometry and tissue response.

Purpose of the Study:

• To develop a regression-informed, proportion-based decision-support framework for breast augmentation.
• To predict postoperative breast proportionality relative to the 45:55 aesthetic target.

Main Methods:

• Utilized standard preoperative breast measurements and implant specifications.
• Developed a composite geometric index (Rib ratio) for implant-breast dimensional matching.
• Incorporated a regression-derived estimate of nipple-to-inframammary crease elongation.
• Constructed a stepwise clinical algorithm with a red-amber-green classification system.

Main Results:

• The framework predicts postoperative breast proportionality based on implant choice and patient anatomy.
• Outcomes are expressed as nipple position relative to total vertical breast height.
• Facilitates comparative assessment of implant options for preoperative planning.

Conclusions:

• The framework offers a structured approach to assess implant-related proportional risk, moving beyond volume-based planning.
• It translates morphometric relationships into a reproducible decision-support model.
• Aids transparent comparison of implant options, acknowledging soft tissue variability and supporting clinical judgment.