The Perfect Breast Shape and Plastic Surgery

Lady in Black the perfect breastHow I got to the “Breast” Shape Ever

Twitter is such a valuable tool for me. A year ago my Twitter account was full of nothing but educational websites. I returned to school to attain my M.Ed. and I used it for the sole purpose of gathering information about the latest “speak” in education. I did not tweet, like, retweet, or DM (direct message). I only lurked and learned.

The lurking and learning changed in October of 2014. School ended for me to focus on my health.  My Twitter account went from education to all things breast cancer and breast reconstruction. I entered the world of plastic surgery as a breast reconstruction patient after undergoing a double mastectomy following a second breast cancer diagnosis. It was a world I was unfamiliar with and had much to learn about both on an academic and emotional level. I was now following, being followed, tweeting, re-tweeting, searching, lurking, learning,  and DM-ing.

A Study of the Perfect Breast

I was captivated by a peer-reviewed study published  by two London-based physicians, Dr. Patrick Mallucci MD FRCS FRCS(Plast) Consultant Plastic Surgeon and Dr. Olivier Alexandre Branford MA, MBBS, PhD, FRCS(Plast) Reconstructive micro-surgeon and aesthetic plastic surgeon. The outcome of the study was to determine the “perfect breast”. The “perfect breast”? Really? I first read this study when I had NO breast after my mastectomy so you can imagine my initial reaction to this study. But, I was going to keep an open mind. The information was gathered and the results were presented and now I could digest that information as a DIEP flap patient who would be working under the skillful hands of a plastic surgeon.

A Fab Tweet Peep Across the Pond

I have DM and tweeted Dr. Branford on several occasions regarding the topic of the “perfect breast” from the standpoint of a breast cancer patient. He is eight hours ahead of me and we have warmly referred to our time difference as “across the pond” but I’ve often wondered if the gentleman requires or even considers sleep in his daily repertoire. This is what I have learned about Dr. Branford, who I fondly refer to as one of my “tweet peeps”. He is a ferocious researcher seeking evidence-based science in his field.  He is an avid and passionate surgeon who exudes a true interest in patient outcomes. He radiates interest not in what he accomplishes but what he can learn and understand about patient satisfaction. I would imagine that is a difficult task to accomplish in the world of aesthetic and plastic surgery. It was that intensity and interest in this study that lured me into an engaged discussion with him albeit miles apart.

45:55concrete bust

The study was comprehensive surveying over 1300 individuals both men, women and plastic surgeons using pictures as a basis for the survey. It included different racial/ethnic groups. The study concluded that the preferred “perfect breast” was a 45:55 ratio. What that translates into is this; If you drew a line horizontally across the nipple of the breast, the upper pole of the breast would contain 45% of breast tissue and the lower pole below the nipple line would contain 55% breast tissue. This was considered the most natural looking breast in contrast to the “bigger is better” breast implants.

Forever 29

I promised Dr. Branford a blog post on this topic and the purpose is to reflect on what a twice diagnosed, bilateral mastectomy, and recent DIEP flap breast reconstruction patient views as the “perfect breast”. If I didn’t think my family and friends would disown me I’d actually post a picture of my now “perfect breasts”. Minus some very well revised scars that will continue to improve and fade over time, suffice to say “the girls” are now 45:55. This 59 year old wife and mother of two adult and beautiful sons is a happy camper. Wrap your mind around that image! Other women told me that upon completion of DIEP flap you will feel like the clock has been turned back thirty years. So, I guess I am forever 29!


A Tool to Achieve Desired Outcomes

The first time I read the article I was admittedly a bit miffed at the implication and wording, “perfect breast”. I’m sure that had a lot to do with my current circumstances when reading the article. Then I realized that this ratio was to be used as a tool.

a basis for design in aesthetic surgery

~Quoted in the article from The American Society of Plastic Surgeons

Plastic surgeons will use this as their guide in achieving desired outcomes that patients will be pleased with. Successful plastic surgeons have to be visionaries, artists, architects and confident that the training they have so passionately pursued will result in a high degree of patient satisfaction. I’ve never asked the question to my or any other plastic surgeon but I would assume that any other outcome would translate into a very bad day at the office for them. They do tend to be perfectionists in their work.

Fashion, Faces and Fantasies

Our society has a fascination with breast beauty and it has definitely evolved over the years influenced by fashion, faces and fantasies! I personally have no problem with attempting to look beautiful but I also believe that it is imperative not to become obsessed with it. I like a great evening out with hair and make up done with a little flirt in my eye as much as the next woman.  But let me just say this, from the standpoint of one who became a bi-lateral breast amputee a year ago and lived with that for seven months, I know I have a far different opinion about  breast beauty than a woman who has a “mommy makeover” or breast implants to correct what time and gravity have done.

I don’t criticize or pretend to know why anyone alters the look of a non-diseased breast and visits a plastic surgeon. These are all individual decisions. The day before I had the final phase of my DIEP flap reconstruction I was sitting face to face with my highly trained and successful plastic surgeon, Dr. Minas Chrysopoulo, who coincidentally enough is also from the UK. I looked at him and said “I never thought in a million years I’d be sitting in a plastic surgeons office much less talking about my breasts. I guess I’m just not that kind of girl.” I have always been of the “work with what you’ve got” school of thinking. Keep it healthy and in shape but don’t mess with it. Embellish as needed.

The Stark Contrast

Before a mastectomy you step out of the shower each morning to look at the image of a woman who is physically whole but just a bit affected by time and gravity. Post mastectomy and as a breast amputee you look at a woman whose very definition of femininity was stripped away by cancer.  You long for the “perfect breast”. So here I was in the mind and world of the plastic surgeon.

My “Breast Friends”

I am glad this study was done. I am glad there is a tool, a template for plastic surgeons to guide them in building the “perfect breast”. I wish this for all women but I’m biased in my desire to want that result for my unintended sisterhood of “breast friends”, those who have lost their breasts to cancer. I like reaching up and feeling what was once a rigid crater made of folds and radiated tissue and is now warm, soft, and all mine.

When I had my final pre-op appointment with Dr. Chrysopoulo I was disrobed and standing in front of the floor to ceiling mirror in his exam room. He carefully looked at the phase one results from the DIEP flap he performed four months prior to phase two. He discussed with me where and from what part of my body he planned to extract fat to achieve symmetry and balance in my breasts. We inject idle chat to ease the appointment. This kind and compassionate gentleman now seems like a trusted friend. We talk about our Twitter peeps, and yes, Oly (as Dr. C refers to him), was mentioned in our conversation. It seemed like a good time to say it so…. I looked at Dr. C and smiled and said, “45:55”. He smiled and said, “Indeed”. The next day Dr. C nailed it!  I now have what I consider to be the perfect breast.

Thank you, Dr. Branford, for this very important study. I look forward to continued articles regarding all things breast reconstruction and pleased I have the honor of knowing such passionate, intelligent and skilled plastic surgeons. I get it now. I get the “perfect breast”. It’s a tool, a guideline for surgeons to achieve desired patient outcomes regarding all things “breast beauty”. I’m no longer offended by the term “perfect breast”. I’m in awe and appreciative of the intended outcomes.girl holding chest


References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website.  The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.