title: The Reliability of Anthropometric Measurements Used Preoperatively in Aesthetic Breast Surgery.
abstract: BACKGROUND
  Patient outcomes in aesthetic breast surgery are highly dependent on breast measurements used in preoperative planning.
  
  
  OBJECTIVE
  The purpose of this study is to determine the reliability of anthropometric breast measurements.
  
  
  METHODS
  Four raters measured 28 women using 7 measurements: sternal notch to nipple distance (Sn-N), nipple to midline (N-M), nipple to inframammary-fold distance under maximal stretch (N-IMF), breast base width (BW), soft tissue pinch thickness of the upper pole (STPT:UP), STPT at the inframammary fold (STPT:IMF), and anterior pull skin stretch (APSS). Reliability was assessed using intra-class correlation coefficients (ICCs).
  
  
  RESULTS
  Inter-rater reliability was excellent for Sn-N, N-M, and BW (ICC = 0.94, 0.90, and 0.76, respectively) and was good for N-IMF (ICC = 0.70). The STPT:UP, STPT:IMF, and APSS measurements were not reliable between raters (ICC < 0.2). Intra-rater reliability was excellent for Sn-N, N-M, and BW for all raters (all ICC > 0.75). The N-IMF intra-rater reliability was excellent in senior raters (ICC > 0.75) and good in junior raters (ICC > 0.6). The STPT:UP, STPT:IMF, and APSS measurements showed fair or poor reliability for most raters (ICC < 0.6).
  
  
  CONCLUSIONS
  The Sn-N, N-M, and BW measurements are very reliable. Dynamic measurements including APSS, STPT:UP, and STUP:IMF are unreliable. N-IMF is the only reliable dynamic measurement, and its reliability improves with increasing clinical experience. The variable reliability of preoperative measurements must be considered in the planning of aesthetic breast surgery.
  
  
  METHODS
  4 Diagnostic.
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kathryn V
authors.initials: KV
authors.lastname: Isaac
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Blake D
authors.initials: BD
authors.lastname: Murphy
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Brett
authors.initials: B
authors.lastname: Beber
authors.affiliation: From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D059925:Anatomic Landmarks; D000886:Anthropometry / Q000379:methods*; D001940:Breast / Q000033:anatomy & histology* / Q000601:surgery; D003357:Cosmetic Techniques; D004954:Esthetics; D005260:Female; D006801:Humans; D015588:Observer Variation; D011237:Predictive Value of Tests; D011300:Preoperative Care; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D055815:Young Adult