Determining breast volume preference among patients, plastic surgeons, and laypeople: Is there a perfect breast size?

BACKGROUND: The female breast comes in many different shapes and sizes. The literature remains inconclusive on the ideal breast size. This study aims to investigate and compare breast size preferences among three cohorts (patients, plastic surgeons, and laypeople) to provide a better understanding of Western European ideals. METHODS: Patients, plastic surgeons, and laypeople were interviewed using a survey containing three-dimensional simulations of nine females, each depicted using five simulations with increasing breast size (1 = natural breast without breast implants, 2 = moderate, 3 = moderate plus, 4 = high, and 5 = ultra-high). Linear regression models were performed to define statistically significant associations between preferred breast size and predictor variables. RESULTS: In total, 28 patients, 45 plastic surgeons, and 100 laypeople (50 males and 50 females) participated in this study. On average, patients (3.5 ± 0.7) preferred larger breast sizes compared to surgeons (3.0 ± 0.7) and laypeople (3.1 ± 0.8). The difference between patients and surgeons was statistically significant. Overall, males preferred larger breast sizes than women. Patients of older age and with a higher BMI preferred larger breast sizes, while higher educational level was significantly associated with smaller breast size preference. Female plastic surgeons would undergo breast augmentation, while male plastic surgeons and female lay participants seem more skeptical. CONCLUSIONS: Significant preferential differences exist between patients and surgeons. It is important for professionals to be aware of societal ideals and preferential differences to adequately consult patients and achieve more satisfactory results.

The Orbital Oval Balance Principle: A Morphometric Clinical Analysis.

BACKGROUND: The aim of this study was to test the validity of the "orbital oval balance principle," a system of analysis and guideline that is used among aestheticians, artists, and makeup artists to create and design aesthetically pleasing eyebrows for optimal upper facial appearance. According to this principle, a face is optimally attractive when the eye is centered in an "oval" defined by the lid-cheek junction and the eyebrow. METHODS: One hundred participants were asked to rank digital morphed images of four female models with four different periorbital proportions: higher or lower lid-cheek junction versus higher or lower eyebrow position. In addition, the participants were asked to quantify seven emotions on these morphed images. RESULTS: A higher lid-cheek junction was rated as significantly more attractive with a lower eyebrow position, and a lower lid-cheek junction was regarded far more attractive in combination with a higher eyebrow position. Moreover, a higher lid-cheek junction was rated as more attractive than a lower lid-cheek junction, and elevation of the lid-cheek junction improved the perception of emotions such as tiredness and sadness. CONCLUSIONS: This study lends support to the orbital oval balance principle that can provide important insight into facial attractiveness to surgeons undertaking procedures intended to improve and rejuvenate facial appearance. Moreover, this study has also shown not only that a high(er) lid-cheek junction is regarded as more youthful and attractive, but that it also may reduce the appearance of tiredness and sadness.

Cosmetic Professionals' Awareness of Body Dysmorphic Disorder.

BACKGROUND: Preoccupation with a perceived appearance flaw is the main feature of body dysmorphic disorder. The majority of these patients seek and often receive some sort of cosmetic procedure, although this condition is considered to be a contraindication. This study evaluates cosmetic professionals' recognition of body dysmorphic disorder and the way they act on this. METHOD: Members of Dutch professional associations for aesthetic plastic surgery, dermatology, and cosmetic medicine received an online survey by means of their association's digital mailing lists; the survey was completed by 173 respondents. RESULTS: Most participants indicated being more or less familiar with the diagnostic criteria and clinical picture of body dysmorphic disorder. Approximately two-thirds of the participants reported that they had encountered between one and five of these patients in their practice over the past year, a percentage that is significantly lower than the estimated prevalence of body dysmorphic disorder. The majority of professionals sometimes or often address body image problems during consultation, most of them collaborate with psychologists or psychiatrists when encountering a patient with body dysmorphic disorder, and approximately 70 percent had refused to perform a procedure in such a patient. CONCLUSIONS: Our results converge with those of previous studies, showing that most cosmetic professionals have some degree of awareness of body dysmorphic disorder, although the number they report encountering in clinical practice departs from prevalence figures. When a patient is identified as having body dysmorphic disorder, the professionals use this knowledge to guide their decision to perform a cosmetic procedure.

Female attitudes regarding labia minora appearance and reduction with consideration of media influence.

BACKGROUND: Labia minora (LM) appearance and reduction have gained increasing media attention in The Netherlands. OBJECTIVE: To determine the prevailing female view about LM appearance and reduction and the role of the media in shaping that view. METHODS: From October 2007 to January 2008, questionnaires designed to elicit prevailing female opinion were distributed to and completed by several groups of females. Survey participants included female medical students at the University of Groningen (n = 394; average age, 22 +/- 3 yrs); patients visiting the outpatient Department of Obstetrics and Gynaecology of the Medical Centre Leeuwarden (n = 51; average age, 40 +/- 13 yrs); and female patients visiting Heerenveen, a private clinic (n = 37; average age, 41 +/- 10 yrs). RESULTS: Most participants (95%) frequently examined their own LM. Almost half of the participants (43%) found the appearance of their LM important and 71% thought that their appearance was normal. Almost all participants (95%) have known about the possibility of LM reduction for the past 2.2 years. Most participants (78%) heard about LM reduction through a media source. Fourteen percent of the total sample found the appearance of their LM to be abnormal, 7% had considered LM reduction, and 0.42% had undergone such a procedure. CONCLUSIONS: Our survey demonstrates that the appearance of LM is important to women and that almost all women surveyed have heard about LM reduction during the past 2.2 years. Our findings probably reflect the influence of increased media attention on this issue in The Netherlands.