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Perceptions of Ideal Breast and Areola Dimensions: A Global Survey of 2,259 Respondents
Annet S. Kuruvilla BS1, Anish Kumar BA2, Taylor J. Ibelli BS MS2, Max Mandelbaum MD2, Madison Greer MD2, Peter W. Henderson MD MBA FACS2
1Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA,2Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA

Background: In almost all forms of breast reconstruction, mastopexy, and breast reduction, surgeons make decisions about resulting areola size, which play an important role in aesthetic results and a patientís self-confidence. Despite the importance of these decisions, no formal study was conducted to identify general views on ideal size. The objective of this study was to broadly survey the global population to understand their perceptions of ideal areola dimensions.
Methods: A survey created using Survey Monkey was completed via Amazon Mechanical Turk over a 24-hour period. Participantsí demographics (sex, age, country, race/ethnicity) were collected. Each participant was provided with 9 composite female torso diagrams (combinations of 3 breast widths and 3 waist widths). For every diagram, each participant selected the most aesthetically pleasing option from 6 available options, with varying areola size (ranging from areola diameter: breast width 1:12 to 6:12).
Results: Among 2,259 participants, with 1,283 male (56.8%) and 976 female (43.2%), the majority of participants were between 25 and 34 years of age (1,012; 44.8%), from the United States (1,669; 73.9%), identified as White (1,430; 63.3%), and had a Bachelorís degree (1,426; 63.1%). Among all 9 combinations, participants were most likely to pick 2:12 (32.89%) (P<0.0001), which shows a tendency to pick a smaller areola size, which looks most aesthetically pleasing irrespective of breast and waist size. The second-most commonly selected was 3:12 (30.61%) with a medium sized areola (P<0.0001). The gender variation showed that males had more of a tendency to choose extreme dimensions of 1:12 or 6:12 in comparison to females (P<0.0001). Across almost all races/ethnic backgrounds, 2:12 was significantly the most popular except among American Indian/Alaskan Native and Middle Eastern where 3:12 was the most picked (P<0.0001). Also, across the top 6 countries (United States, India, Brazil, Italy, Canada, United Kingdom), the United States, India and Italy had 2:12 as the most selected and Brazil, Canada, and the United Kingdom had 3:12 as the most preferred (P<0.0001).
Conclusions: While there is no substitute for knowing each individual patientís preferences for areola size, this study provides the first generalized objective assessment of the publicís impression of ideal areola proportions, which can guide surgical decision making in reconstructive procedures.


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