Assessment of the Aesthetic Relationship Between the Female Breast and the Lateral Chest Wall: Important Considerations for Breast Augmentation, Breast Reduction, and Breast Reconstruction Surgery.

Background: The contribution of the lateral chest wall to overall aesthetic outcome following breast augmentation, breast reduction, or breast reconstruction has been understudied. This study aims to determine if a patient-perceived "ideal" lateral extension of the chest wall exists and whether it is influenced by respondents' demographic factors or body perceptions.

Objectives: This study seeks to provide plastic surgeons with valuable insights to optimize aesthetic results in breast procedures and better manage patient expectations.

Methods: Realistic female figures were modeled to represent different body types. For each body type, three torsos were created with increasing lateral chest wall fullness (concave, neutral, and full) were created. An anonymous online survey was sent to subscribers of a beauty magazine to determine their aesthetic preference towards lateral chest wall contours related to their perceived body type.

Results: A total of 1,131 individuals responded to the survey, with 894 meeting the inclusion criteria. 48.7% selected the neutral lateral chest wall as the most aesthetically appealing, 46.0% the concave contour, and 5.3% the full contour. First-choice preferences varied significantly by self-selected body type (P<0.001) and cosmetic procedure history (P=0.01). With increasing BMI, respondents ranked the concave contour less favorably (P<0.001), while the neutral (P=0.007) and full (P=0.01) contours received higher rankings.

Conclusions: The aesthetics of the lateral chest wall are highly dependent on individual anatomy as well as patient perception of their body morphology. A contour ranging from slightly concave to neutral is generally preferred, with preferences correlating directly with body composition. These insights suggest that plastic surgeons should discuss the lateral chest wall with patients in consultation for breast procedures. Additionally, surgeons should adopt personalized surgical plans that consider the breast-chest wall relationship and integrate ancillary procedures to optimize patient satisfaction.