The AAPS 101st Annual Meeting

Differential Sex Preferences in Breast Aesthetics

Background

Breast aesthetics are a highly discussed topic within plastic surgery

Dearth of information pertaining to how preferences differ amongst various demographic groups

Mullucci et al. 2012 assessed an international population to determine preferences of breast aesthetics

Found 45:55 ratio of upper to lower pole volume as ideal

Bekisz et. Al. 2023

Survey of U.S. population based on census; reverse engineer ideal breast based on survey respondents

Purpose of Study

The objective of this study was to assess how preferences of breast aesthetics differ by the self-identified sex of the respondent.

Methods

A cohort of 25 patients from the senior surgeon’s practices presenting for aesthetic or reconstructive breast surgery was assembled.

This cohort was selected with the aim of choosing a sample that maximized diversity based on breast size and shape, skin tone, and nipple-areola complex size and position.

A survey was constructed to assess respondents’ impressions of “breast attractiveness.” Surveys accompanied with pre-operative anteroposterior photographs from these patients were distributed via Qualtrics (Seattle, WA), which allowed for a representative sample of the United States.

Respondents were asked to rate breasts on a Likert scale of 1 to 5, with 1 being not at all attractive and 5 being most attractive.

Survey responses were analyzed for differences in breast aesthetic preferences by sex.

Statistical analysis independent t-tests and Pearson correlation coefficients with a predetermined level of significance of p<0.05.

Data

A total of 1,021 survey responses

Survey respondents represented the age, gender identity, sexual orientation, and racial and ethnic backgrounds which was representative of the United States population documented in the 2020 census

52.6% were female, 47% were male

Males rated any given pair of breasts as 17% more attractive than females did (range 3-34%, p=0.005).

Considering sex assigned at birth, males rated all breasts higher than females (2.8 vs 2.5, p<0.0001).

Despite this discrepancy, ratings amongst male and female respondents were highly correlated (R=0.940; R2=0.884; p<0.0001).

In a sample representative of the United States, a difference in breast aesthetic appraisal was observed by sex.

Males found each breast more aesthetically pleasing than their female counterparts, though ratings were highly correlated

This finding may be important when considering sex-discordant patient-physician pairings and warrants further investigation.

The AAPS 101st Annual Meeting

Differential Sex Preferences In Breast Aesthetics

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