LAUSR

BACKGROUND Breast augmentation patients are often unaware of their preexisted breast asymmetry before the surgery but discover it afterward, which leads to postoperative dissatisfaction and increases the reoperation rate. However, elaboration on how patients subjectively analyze breast asymmetry and the recognition thresholds was limited. METHODS Two hundred female participants, including 100 six-months postoperative patients for primary augmentation mammaplasty, and 100 preoperative ones, were recruited as two study groups. Self-assessments of breast asymmetry and objective measurements were taken. A computerized recognition experiment was constructed based on standardized 3D models with different NAC and IMF asymmetry combinations. One hundred and twenty-one 3D models were generated and shown in random sequence. Participants responded whether they discovered breast asymmetry in each model. The recognition rate and 50% recognition thresholds of the asymmetry in NAC, IMF, lower pole length, volume and their interrelations were calculated. RESULTS Self-assessment of the post-augmentation group showed a more precise distinguishment of NAC, IMF, and lower pole distance asymmetry than the pre-augmentation group. The 50% recognition thresholds of NAC and IMF level discrepancies were approximately 0.75cm, with the IMF asymmetry identified with higher accuracy. When the NAC level discrepancy ranged from 0.0cm to 1.25cm, adjusting the IMF level discrepancy from 0.0cm to 0.5cm in the same direction lowered participants' recognition rates of breast asymmetry. CONCLUSION Patients recognize their breast asymmetry issue more accurately after augmentation surgeries, despite improved parameters. In addition, adjusting the new IMF level aligning with NAC discrepancy within 0.5cm when treating mild NAC asymmetry improved symmetrical outcomes.