title: Breast Durometer (Mammometer): A Novel Device for Measuring Soft-Tissue Firmness and Its Application in Cosmetic Breast Surgery.
abstract: The measurement of soft-tissue firmness has many potential applications in medical practice. This study reports a user-friendly, novel device that is capable of measuring changes in soft-tissue firmness in a reproducible manner. The study reports the development of the equipment and how it has been applied to breast implant surgery. The device was tested for both intra- and inter-observer variability on an in vitro model, using a breast implant. Once reproducibility was confirmed, breast firmness was measured on a series of patients who underwent sub-fascial breast augmentation (n = 50) to examine how it varied post-operatively. Firmness in the upper half of the breast increased to a maximum level two weeks post-surgery (0.44-0.61 Pa), reducing to pre-operative levels by 6 weeks (0.37-0.54 Pa). There was no further significant change at 12 weeks. Firmness in the nipple areolar complex (NAC) and at the lower outer quadrant (LOQ) followed a similar pattern, but remained firmer at 12 weeks. We interpret these patterns as implying that measurements taken at the upper half of the breast are indicative of post-operative oedema, whereas those at the NAC and LOQ represent changes in firmness produced by the breast implant composite. We consider the potential for this novel device in the measurement of soft-tissue firmness in aesthetic breast surgery and would encourage other researchers to explore novel applications. Level of Evidence III 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.affiliation: , First Floor, Suite 2, 40 Clyde Road, Berwick, VIC, 3806, Australia. tim@timbrown.com.au.
authors.forename: Tim
authors.initials: T
authors.lastname: Brown
authors.affiliation: , First Floor, Suite 2, 40 Clyde Road, Berwick, VIC, 3806, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Brown
authors.affiliation: , First Floor, Suite 2, 40 Clyde Road, Berwick, VIC, 3806, Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: Murphy
mesh_terms: D001696:Biomechanical Phenomena; D001940:Breast / Q000502:physiology / Q000503:physiopathology* / Q000601:surgery; D019928:Breast Implantation; D018427:Breast Implants; D004487:Edema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006801:Humans; D057910:Implant Capsular Contracture / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D066298:In Vitro Techniques; D016462:Mammaplasty; D008365:Manometry / Q000295:instrumentation*; D009558:Nipples / Q000502:physiology / Q000503:physiopathology* / Q000601:surgery; D015588:Observer Variation; D015203:Reproducibility of Results
keywords: Breast; Firmness; Measurement; Tissue turgor