title: The Aesthetically Ideal Position of the Nipple-Areola Complex on the Breast.
abstract: BACKGROUND
  Several studies have attempted to identify an objective description of the aesthetically ideal breast, but they have all suffered in their reliability because of having several intrinsic limitations. It is therefore essential to design a template of ideal breast features in order to predict and evaluate aesthetic outcomes in both reconstructive and cosmetic breast surgery. The aim of this study was to determine the aesthetically preferred position of the nipple-areola complex on the breast.
  
  
  METHODS
  A questionnaire was sent by regular mail to 1000 men and 1000 women aged between 16 and 74 years. They were asked to rank the attractiveness of a series of breasts of women in images with different NAC positions. The images showed breasts from two different angles: 12 frontal-view images with both breasts shown, and five side-view images with only one breast shown. All of the breasts had equal dimensions and proportions, with the same areola size but different NAC positions. Statistical analysis of data was carried out.
  
  
  RESULTS
  Eight hundred and thirteen of 2000 participants completed the questionnaire. The NAC placement preferred by both genders had a ratio of 40:60 x and 50:50 y, which means that it was best situated in the middle of the breast gland vertically and slightly lateral to the midpoint horizontally. Significant differences were found between the age and gender subgroup preferences.
  
  
  CONCLUSIONS
  This study identified the preferred position of the nipple-areola complex on the female breast in the general population. This is an important information when planning breast reconstructive and cosmetic surgery.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors: Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden. richard.lewin@vgregion.se.
authors: Richard
authors: R
authors: Lewin
authors: Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden.
authors: Matteo
authors: M
authors: Amoroso
authors: Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden.
authors: Nikolina
authors: N
authors: Plate
authors: Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden.
authors: Clara
authors: C
authors: Trogen
authors: Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden.
authors: Gennaro
authors: G
authors: Selvaggi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001940:Breast / Q000033:anatomy & histology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000033:anatomy & histology / Q000601:surgery*; D057240:Patient Preference; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Aesthetic breast; Breast surgery; Nipple position on the breast