Variables affecting symmetry of the nipple-areola complex

Currently, little is known about which variables are most critical to the subjective appearance of symmetry of the nipple-areola complex. Clinical photographs were transferred onto a compact disc and then imported into a computer photoshop program. Alterations to the nipple-areola complex were then performed, creating 1 symmetrical image and 19 asymmetrical images. The asymmetries were produced by altering position, diameter, or pigmentation. The images were converted to 35-mm slides and shown to four separate panels of three members each. A "symmetry score" was given for each slide. Results showed that any deviation from symmetrical was reliably detectable by the observers. Changes in areola diameter were detected most easily, and the specific direction of positional change was not found to be a significant factor. Differences were seen between individual panel assessments. This study has shown an application for CD-ROM technology in analyzing well-identified variables and has helped in delineating which factors are most critical to the subjective impression of symmetry of the nipple-areola complex.