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This  classification  system  is  applicable to  all breast  sizes.   Financial support and sponsorship
         It is based on the appearance of the cleavage and takes in   Nil.
         to account the width of the cleavage at the superior and
         inferior poles of the breast, and the midpoint between them.   Conflicts of interest
         In women with smaller breasts the cleavage will be more   There are no conflicts of interest.
         pronounced, and different than that of women with fuller
         breasts. However, the authors believe that even in women   REFERENCES
         with smaller breasts the shape of the cleavage should vary
         according  to  our classification system.  In  this  cohort of   1.   Oliver R. I'll boost your boobs or go bust! Plastic Surgery 101, 2007.
         patients the more prevalent classes would be the hour glass,   Available  from:  http://plasticsurgery101.blogspot.com/2007_08_01_
         and the hi-ball glass (anteroposterior view) and the margarita   archive.html. [Last accessed on November 24, 2015]
         glass, and the tumbler glass (craniocaudal view). Similarly   2.   West's federal supplement (First Series).   Victoria, Minnesota:  West
         for women with larger breasts one would expect to observe   Publishing Co; 1990. p. 994.
         cocktail glass and champagne glass (anteroposterior view)   3.   Eisenberg T, Eisenberg J. The scoop on breasts: a plastic surgeon busts
                                                                 the myths. 1st ed. Philadelphia: Incompra Press; 2012.
         and cocktail and goblet glass (craniocaudal view).   4.   Hsu VM, Tahiri Y, Wes AM, Yan C, Selber JC, Nelson JA, Kovach SJ, Serletti
                                                                 JM, Wu LC. Does breast reconstruction impact the decision of patients to
         Patient satisfaction after breast augmentation is variable and   pursue cosmetic surgery? Ann Plast Surg 2014;73:S144-8.
         some studies have reported that not all patients are satisfied   5.   Gladfelter J, Murphy D. Breast augmentation motivations and satisfaction:
         with their postoperative outcomes. [5,10,17]  It depends on   a prospective study of more than 3,000 silicone implantations. Plast Surg
         multiple aspects of the appearance of the breasts including   6.   Nurs 2008;28:170-4.
                                                                 Gernsheim A. Victorian  and  Edwardian  Fashion: A  Photographic  Survey
         their shape, size, contours as well as the appearance of the   (Dover Fashion and Costumes). New York: Dover Publications, 1982.
         cleavage. Patients are unique and any given cleavage may   7.   Morris D. The naked woman: a study of the female body. Reprint edition.
         not necessarily fit one particular classification. However,   New York: St. Martin's Griffin; 2007.
         this  classification based  on various everyday shapes of   8.   Spooner C. Fashioning gothic bodies. Manchester: Manchester University
         glasses, can be used by surgeons to help patients acquire   Press; 2004. p. 28.
         an objective understanding regarding their expectations   9.   Condra J. The greenwood encyclopedia of clothing through world history.
                                                                 Westport, Connecticut: Greenwood Publishing Group; 2008. p. 152.
         from surgery. Surgeons can use this  classification system   10.  McCarthy CM, Cano SJ, Klassen AF, Scott A, Van Laeken N, Lennox PA,
         preoperatively to discuss the expectations of patients   Cordeiro PG, Pusic  AL.  The magnitude of effect of cosmetic breast
         regarding the appearance of their cleavage in addition to   augmentation on patient satisfaction and health-related quality of life. Plast
         their breasts. If patients desire a certain type of cleavage   Reconstr Surg 2012;130:218-23.
         after  their  augmentation  the  surgeon  can modify  their   11.  Dini  GM,  Gozzano  R,  Ferreira  RB,  Faria  M,  Farinazzo  M,  Ferreira  LM.
                                                                 Mirror, mirror on the wall, which breast is bigger of them all. Plast Reconstr
         choice of implants and their surgical technique accordingly.   Surg Glob Open 2014;2:e105.
         A breast augmentation procedure as well as the choice of   12.  von Heimburg D, Exner K, Kruft S, Lemperle G. The tuberous breast
         implant may then be altered, taking into consideration not   deformity: classification and treatment. Br J Plast Surg 1996; 49:339-45.
         only the desired increase or decrease in breast size but also   13.  India M. Breasts - structures  and  types.  Available from: http://www.
         the desired modification of cleavage appearance.        medindia.net/patients/patientinfo/breasts-structures-and-types-breast-
                                                                 types.html. [Last accessed on November 24, 2015]
                                                             14.  Room H. Classify your breast. Available from: http://www.herroom.com/
         Though the proposed classification is  based on personal   breast-shape,336,30.html. [Last accessed on November 24, 2015]
         observations and the nomenclature of glasses, we believe   15.  Chasan PE. A new breast shape classification. Plast Surg Pract 2011.
         that if used in conjunction with the existing  practices   16.  Kolker AR, Collins MS. Reply:  tuberous breast deformity: classification and
         of breast augmentation,  it will result in an improved   treatment strategy for improving consistency in aesthetic correction. Plast
         aesthetically  pleasing  outcome  leading to  better  patient   Reconstr Surg 2015;136:e269-70.
         satisfaction with the results of the augmentation. Our   17.  Young VL, Nemecek JR, Nemecek DA. The efficacy of breast augmentation:
                                                                 breast  size  increase,  patient  satisfaction,  and  psychological  effects.  Plast
         proposed classification should be further explored by formal   Reconstr Surg 1994;94:958-69.
         studies that analyze both preoperative and postoperative   18.  Galdino GM, Nahabedian M, Chiaramonte M, Geng JZ, Klatsky S, Manson
         patient satisfaction. This analysis could be either  a two-  P. Clinical applications of three-dimensional photography in breast surgery.
         dimensional e.g. using photographs or three-dimensional   Plast Reconstr Surg 2002;110:58-70.
         analysis [18,19]   and lead to better  understanding  of role of   19.  Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A,
         preoperative and postoperative cleavage morphology in   Udosic K, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E. New
                                                                 aspects of breast volume measurement using 3-dimensional surface
         patient satisfaction.                                   imaging. Ann Plast Surg 2006;57:602-10.















         38                                                                   Plast Aesthet Res || Vol 3 || Issue 1 || Jan 15, 2016
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