Female health,attractiveness, and desirability for relationships: Role of breast asymmetry and waist-to-hip ratio

Fluctuating asymmetry (FA) of ordinarily bilaterally symmetrical traits in humans has been proposed to indicate developmental anomaly. Recent research has shown that individuals with minimal FA are judged to be attractive, and preferred as sexual partners (Thornhill and Gangestad 1993). Waist-to-hip ratios (WHR) have been also shown to reflect health and reproductive capability of woman and those with low WHRs are judged more attractive and healthy (Singh 1993a,b). The present study examines the relative roles of WHR and FA in female breasts in judgments of female attractiveness, health, and desirability for short-term and long-term relationships. Male college students were asked to judge attractiveness of female figures that differed in WHR (high and low) and breast symmetry (none, low, or high). In the first test, paired comparison method was used in which each figure was paired one at a time with all other figures. In the second test, subjects examined all figures simultaneously, estimated their age, and rated each figure for attractiveness, feminine looks, health, overall degree of body symmetry, and willingness to engage in short- and long-term relationship. Results from both tests show that figures with low WHRs were judged to be more attractive than figures with high WHRs, regardless of their degree of breast asymmetry. The figure with low WHR and symmetrical breasts was judged to be most attractive and youngest of all other figures. It appears that men use both WHR and breast asymmetry in judging attractiveness and being willing to develop romantic relationships. It is proposed that WHR and breast asymmetry may signal different aspects of overall female mate quality.     

Breast base anomalies: treatment strategy for tuberous breasts, minor deformities, and asymmetry

A variety of breast deformities of differing appearances can be grouped together within an extensive syndrome that is characterized by anomalies of the breast base and preferentially involves the lower quadrants. Tuberous breasts are the most typical, but not the only, form of the deformity. The authors studied a series of 37 patients who had breast surgery, and they used a classification of three types: I, II, and III (in increasing order of severity). In type I breasts (minor form), only the lower medial quadrant is deficient; in type II breasts, both lower quadrants are deficient; and in type III breasts, all four quadrants are deficient. The study showed a predominance of minor forms (54 percent of breasts operated on) and of combinations including at least one minor form (81 percent of patients). Seventy percent of women had a breast asymmetry of more than 100 g. Only 27 percent of breasts operated on were hypotrophic, 45 percent were of normal volume, and 28 percent were hypertrophic. The authors propose a procedure to treat the minor forms of the deformity, using a mammaplasty with a superior pedicle and a lower lateral dermoglandular flap to fill the deficient lower medial quadrant. They define the indications of the classic techniques according to the type of deformity and stress the frequent need for secondary revision.     

Breast asymmetry,sexual selection,and human reproductive success

Breasts of human females are large compared to those of closely related primate species, and they can thus be hypothesized recently or currently to have been subject to directional sexual selection. Here we show that (1) large breasts have higher levels of fluctuating asymmetry than small breasts, (2) breast fluctuating asymmetry is higher in women without children than in women with at least one child, (3) breast fluctuating symmetry is a reliable predictor of age-independent fecundity, and (4) breast fluctuating symmetry appears to be associated with sexual selection. These conclusions were similar in studies from two cultures differing in fecundity and breastfeeding traditions (Spain; New Mexico, U.S.A.). Choosy males that prefer females with symmetrical breasts may experience a direct fitness benefit in terms of increased fecundity and an indirect benefit in terms of attractive or fecund daughters.     

Men's preferences for women's breast size and shape in four cultures

The morphology of human female breasts appears to be unique among primates due to their permanent fat deposits. It has been previously suggested that female breast morphology arose as a result of sexual selection. This is supported by evidence showing that women with larger breasts tend to have higher estrogen levels; breast size may therefore serve as an indicator of potential fertility. However, breasts become less firm with age and parity, and breast shape could thus also serve as a marker of residual fertility. Therefore, cross-culturally, males are hypothesized to prefer breast morphology that indicates both high potential and residual fertility. To test this, we performed a survey on men's preferences for breast morphology in four different cultures (Brazil, Cameroon, the Czech Republic, Namibia). As stimuli, we used two sets of images varying in breast size (marker of potential fertility) and level of breast firmness (marker of residual fertility). Individual preferences for breast size were variable, but the majority of raters preferred medium sized, followed by large sized breasts. In contrast, we found systematic directional preferences for firm breasts across all four samples. This pattern supports the idea that breast morphology may serve as a residual fertility indicator, but offers more limited support for the potential fertility indicator hypothesis. Future studies should focus on a potential interaction between the two parameters, breast size and firmness, which, taken together, may help to explain the relatively large variation in women's breast sizes.     

Our experience with reconstruction of the breast

Breast reconstruction in female patients undergoing mastectomy for breast cancer (17 patients) or benign breast disease (2 patients), and malformation of breast due to asymmetry (19 patients) was started in 1983. Mastectomy in 10 patients was performed because of the cancer, and in 17 patients due to benign breast disease. Age of patients ranged from 15 to 58 years. Breast reconstruction was performed within 1-12 years following mastectomy. Two different methods of reconstruction were applied: a) flap graft of patient's own skin and muscle from latissimus muscle of the back with silastic prosthesis implanted under graft (12 breasts), and b) implantation of the prosthesis only (28 breasts). Correction of the opposite breast was also made in 3 patients. No complications are seen up-to-date. Esthetic results are also satisfactory.     

Resource Security Impacts Men’s Female Breast Size Preferences

It has been suggested human female breast size may act as signal of fat reserves, which in turn indicates access to resources. Based on this perspective, two studies were conducted to test the hypothesis that men experiencing relative resource insecurity should perceive larger breast size as more physically attractive than men experiencing resource security. In Study 1, 266 men from three sites in Malaysia varying in relative socioeconomic status (high to low) rated a series of animated figures varying in breast size for physical attractiveness. Results showed that men from the low socioeconomic context rated larger breasts as more attractive than did men from the medium socioeconomic context, who in turn perceived larger breasts as attractive than men from a high socioeconomic context. Study 2 compared the breast size judgements of 66 hungry versus 58 satiated men within the same environmental context in Britain. Results showed that hungry men rated larger breasts as significantly more attractive than satiated men. Taken together, these studies provide evidence that resource security impacts upon men’s attractiveness ratings based on women’s breast size.     

Reliability of inferior pedicle reduction mammaplasty in burned oversized breasts

Heavy pendulous breasts cause physical and psychological trauma. Postburn deformity of breasts results in significant asymmetry, displacement of nipple-areola complex, due to burn scar contracture, and significant scarring; these factors add more psychological discomfort and subsequent behavioral changes. The use of the inferior pedicle procedure in burned breasts can solve many problems. The technique reduces the size of the large breast, eliminates the scar tissue by excising both medial and lateral flaps, and brings the mal-located nipple and areola to a normal position. This study stresses the possibility of harvesting the inferior dermal pedicle flap from within the postburn scar tissue without necrosis of the nipple and areola, because of the excellent flap circulation. Acceptable aesthetic appearance and retainment of nipple viability and sensitivity can be achieved with the inferior pedicle technique even with postburn deformity of the breast. The study was conducted on 11 women, all of whom had sustained deep thermal burns to the breasts and anterior torso and whose breasts were hypertrophied and pendulous.     

Practical do-it-yourself device for accurate volume measurement of breast

A simple and accurate method of measuring differences in breast volume based on Archimedes' principle is described. In this method, a plastic container is placed on the breast of the patient who is lying in supine position. While the breast occupies part of the container, the remaining part is filled with water and the volume is measured. This method allows the measurement of the volume differences of asymmetric breasts and also helps the surgeon to estimate the size of the prosthesis to be used in augmentation mammaplasty.     

Large breasts and narrow waists indicate high reproductive potential in women

Physical characteristics, such as breast size and waist-to-hip ratio (WHR), function as important features used by human males to assess female attractiveness. Males supposedly pay attention to these features because they serve as cues to fecundity and health. Here, we document that women with higher breast-to-underbreast ratio (large breasts) and women with relatively low WHR (narrow waists) have higher fecundity as assessed by precise measurements of daily levels of 17-beta-oestradiol (E2) and progesterone. Furthermore, women who are characterized by both narrow waists and large breasts have 26% higher mean E2 and 37% higher mean mid-cycle E2 levels than women from three groups with other combinations of body-shape variables, i.e. low WHR with small breasts and high WHR with either large or small breasts. Such gains in hormone levels among the preferred mates may lead to a substantial rise in the probability of conception, thus providing a significant fitness benefit.     

Virginal hypertrophy

A patient with extensive juvenile hypertrophy of the breasts has been presented. Several interesting facts in the case history are as follows: After pregnancy, the breasts did not regress with "hormone shots" to stop lactation. The patient took high-dosage estrogen birth control pills for 3 years before the breasts started to grow rapidly. Within 1 month after reduction mammaplasty and despite 20 mg dydrogesterone per day, the breasts started to enlarge. A total of 60 mg b.i.d. of dydrogesterone did not stop breast regrowth. Tamoxifen citrate did cause regression of the breasts. After two reductions, the breasts regrew with a subsequent pregnancy. The breast tissue regrew in the axilla with a subsequent pregnancy after simple mastectomy-subcutaneous mastectomy and free nipple transplants. Chronic marijuana use may have an effect on the breast tissue in certain susceptible females as well as in some males. Much needs to be learned about the control of growth of female breast tissue.     

Guidelines in concentric mastopexy

The scope and technique of concentric mastopexy remain unclear and controversial. In our hands, the procedure has application for mild nipple ptosis, glandular ptosis, and areola asymmetry, as well as the tuberous breast. Early disappointment has changed to increasing satisfaction as we have gained confidence in predicting our results based on the identification of three simple principles of concentric mastopexy. The first and most important, which states Doutside less than or equal to Doriginal + (Doriginal - Dinside), requires that the outer concentric circle must be drawn not to exceed the original areola diameter by more than the original areola diameter exceeds the inner concentric circle diameter. The second principle, Doutside less than or equal to 2 X Dinside, recommends that the outer circle diameter be drawn not to exceed twice that of the inner circle, to prevent poor scarring or over flattening of the breast. The third principle, Dfinal = 1/2(Doutside + Dinside), allows prediction of the final areola size as the average of the diameters of the inner and outer concentric circles. These three principles allow excision of a maximum amount of areola and periareola skin without the side effect of poor scars, dilated areola, or misshapened breasts. Applying these three principles to concentric mastopexy with or without augmentation mammaplasty, one may confidently correct a wide variety of deformities, producing more symmetrical, attractive breasts with areolae of a predictable size.     

Breast volume measurement of 248 women using biostereometric analysis

A study of volumes of the right and left breasts of 248 subjects was undertaken using biostereometric analysis. This measurement technique uses close-range stereophotogrammetry to characterize the shape of the breast and is noncontact, noninvasive, accurate, and rapid with respect to the subject involvement time. Volumes and volumetric differences between breast pairs were compared, using chi-square tests, with handedness, perception of breast size by each subject, age, and menstrual status. No significant relationship was found between the handedness of the subject and the larger breast volume. Several groups of subjects based on age and menstrual status were accurate in their perception of breast size difference. Analysis did not confirm the generally accepted clinical impression of left breast volume dominance. Although a size difference in breast pairs was documented, neither breast predominated.     

Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging

Differences in breast volume and contour are subjectively estimated by surgeons. 3D surface imaging using 3D scanners provides objective breast volume quantification, but precision and accuracy of the method requires verification. Breast volumes of five test individuals were assessed using a 3D surface scanner. Magnetic resonance imaging (MRI) reference volumes were obtained to verify and compare the 3D scan measurements. The anatomical thorax wall curvature was segmented using MRI data and compared to the interpolated curvature of the posterior breast volume delimitation of 3D scan data. MRI showed higher measurement precision, mean deviation (expressed as percentage of volume) of 1.10+/-0.34% compared to 1.63+/-0.53% for the 3D scanner. Mean MRI [right (left) breasts: 638 (629)+/-143 (138) cc] and 3D scan [right (left) breasts: 493 (497)+/-112 (116) cc] breast volumes significantly correlated [right (left) breasts: r=0.982 (0.977), p=0.003 (0.004)]. The posterior thorax wall of the 3D scan model showed high agreement with the MRI thorax wall curvature [mean positive (negative) deviation: 0.33 (-0.17)+/-0.37 cm]. High correspondence and correlation of 3D scan data with MRI-based verifications support 3D surface imaging as sufficiently precise and accurate for breast volume measurements.     

Autologous breast reconstruction with the extended latissimus dorsi flap

The extended latissimus dorsi myocutaneous flap can provide autogenous tissue replacement of breast volume without an implant. Nevertheless, experience with the extended latissimus dorsi flap for breast reconstruction is relatively limited. In this study, the authors evaluated their experience with the extended latissimus dorsi flap for breast reconstruction to better understand its indications, limitations, complications, and clinical outcomes. All patients who underwent breast reconstruction with extended latissimus dorsi flaps at the authors' institution between January of 1990 and December of 2000 were reviewed. During the study period, 75 extended latissimus dorsi flap breast reconstructions were performed in 67 patients. Bilateral breast reconstructions were performed in eight patients, and 59 patients underwent unilateral breast reconstruction. There were 45 immediate and 30 delayed reconstructions. Mean patient age was 51.5 years. Mean body mass index was 31.8 kg/m2. Flap complications developed in 21 of 75 flaps (28.0 percent), and donor-site complications developed in 29 of 75 donor sites (38.7 percent). Mastectomy skin flap necrosis (17.3 percent) and donor-site seroma (25.3 percent) were found to be the most common complications. There were no flap losses. Patients aged 65 years or older had higher odds of developing flap complications compared with those 45 years or younger (p = 0.03). Patients with size D reconstructed breasts had significantly higher odds of flap complications compared with those with size A or B reconstructed breasts (p = 0.05). Obesity (body mass index greater than or equal to 30 kg/m2) was associated with a 2.15-fold increase in the odds of developing donor-site complications compared with patients with a body mass index less than 30 kg/m2 (p = 0.01). No other studied factors had a significant relationship with flap or donor-site complications. In most patients, the extended latissimus dorsi flap alone, without an implant, can provide good to excellent autologous reconstruction of small to medium sized breasts. In selected patients, larger breasts may be reconstructed with the extended latissimus dorsi flap alone. This flap's main disadvantage is donor-site morbidity with prolonged drainage and risk of seroma. Patients who are obese are at higher risk of developing these donor-site complications. In conclusion, the extended latissimus dorsi flap is a reliable method for total autologous breast reconstruction in most patients and should be considered more often as a primary choice for breast reconstruction.     

Short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty

A method of breast reduction is presented that maintains the blood supply and innervation to the nipple and areola complex by means of an inferior pedicle, reduces the breast volume by removing tissue from the periphery of the breast, maintains breast shape with internal plication sutures, and limits the scar using a periareolar technique with a short inferior vertical-to-oblique extension. There were 167 breasts in 98 patients reduced in this fashion. The average resection volume was 632 g per breast, with an average follow-up of 7.6 months. The complication rate was similar to that observed using traditional inferior pedicle techniques with the inverted-T cutaneous scar. This technique has proven to be versatile, technically straightforward, and applicable to breasts of all sizes for both breast reduction and mastopexy. By combining the aesthetic advantage of less cutaneous scarring with the safety and familiarity of the inferiorly based pedicle, superior results in breast reduction can be obtained that are consistent, long-lasting, and satisfying for both patient and surgeon alike.     

SIZE,SYMMETRY, AND SEXUAL SELECTION IN THE HOUSEFLY,MUSCA DOMESTICA

Relationships between measures of body size, asymmetry, courtship effort, and mating success were investigated in the housefly, Musca domestica (Diptera: Muscidae). A previous study indicated that both male and female flies with low fluctuating asymmetry enjoyed enhanced mating success. The aim of our investigations was to determine whether the greater success of symmetrical males is due to variation in male mating effort or to female choice and whether males exhibited mate choice. However, our study found directional rather than fluctuating asymmetry with both male and female flies having, on average, longer left wings than right. Also, asymmetry was not related to mating success in either sex. Rather, both males and females appeared to exhibit choice on the basis of the size of potential mates, with males preferring females with long bodies and females preferring heavy males. Possible benefits from choice of large mates are discussed. The initial mating strikes (in which the male leaps onto the back of the female) did not appear to be targeted according to female morphology, and their frequency did not vary according to male morphology. This indicates that mate choice by both sexes according to size probably occurs during the later stages of courtship, when the flies are in intimate contact. Possible reasons for the absence of choice according to asymmetry are discussed.     

Measurement of breast volume: comparison of techniques

A system of graduated disks has been previously described as a method to determine breast volume. The accuracy and limitations of this system have not previously been reported. Comparison of these disks with a standardized volumetric method shows this simple system to be accurate. Standard linear correlation analysis was good for the entire group of breasts measured (r = 0.718). Conversion to true volume M is represented by the least-square line M = 20.33 + 1.37G. The correlation is expected to fail at volumes greater than 425 cc (greater than the calibration on the largest Grossman disk). Elimination of volumes greater than 425 cc, however, produced no improvement in correlation coefficient. Firm breasts (i.e., capsular contractures) displace less uniformly into the conical restraint of the disk and cause an overestimation of their volume. Three breasts in this series were evaluated with Baker grade III and IV capsular contractures. Elimination of these values improved the correlation between the two volume analyses (r = 0.853 and M = 1.56G - 4.48). We suggest that when confronted with very large or firm breasts that volumes determined by the Grossman disk be interpreted with care. A formula for calculation of the true breast volume from the Grossman measurement has been derived and presented.     

Human breasts: Unsupported hypotheses reviewed

Unlike other apes, human females’ breasts develop before first pregnancy and are permanently enlarged. Evidence suggests breasts act as signals to males but the critical data required to confirm this are lacking. These facts have led to a number of hypotheses about the evolutionary and adaptive significance of the human breast which fall into two groups. Those that address the presence of breasts in humans are (a) that they act as releasers of male sexual behaviour, (b) that they enable females to hide their reproductive condition, and (c) that they allow infants to nurse from their mother’s hip. Those that address variability in breast size are (d) that large breasts indicate lactational potential, (e) ability of mothers to invest prenatally in offspring, (f) mother’s fecundity, and (g) her longevity. Each hypothesis is reviewed and evaluated using logical or empirical arguments. Possible ways in which the adaptive significance of human breasts can be determined in contemporary populations are outlined.     

Age‐related sexual plumage dimorphism and badge framing in the European Robin Erithacus rubecula

Male and female European Robins Erithacus rubecula display their red breasts in year‐round territorial contests. Despite the clear signalling role of the red breast, little is known about its sexual dimorphism or trends in size when Robins age. We studied these patterns in resident and migrant Robins in a Mediterranean population. Both male and female first‐year Robins had smaller red breasts than second‐year individuals. Females, but not males, showed a reduction in badge area after the second year of life, leading to sexual dimorphism in red breast area in the oldest Robins. The grey fringe around the red breast showed a steady increase in width in males when ageing, but not in females, also leading to sexual dimorphism in this trait among oldest Robins. The contrast between the red breast and its surrounding grey fringe was higher than that between the breast and the back at both high and low environmental light intensities. This suggests that the grey fringe could function as a frame to highlight the perimeter of the red breast, and that the Robin’s plumage is equally suited to display in open areas and forest understoreys. Our study suggests that the extent of the red breast and its grey frame could confer information about the age and sex of the birds, and thus be used as a signal in territorial contests and mating decisions.     

Carcinoma of the breast with malignant epithelial giant cells. Needle aspiration cytology, immunocytochemistry and electron microscopy in a rare case in a woman under 30.

Needle aspiration cytology, immunocytochemistry and electron microscopic findings are described in a case of rare breast carcinoma with bizarre, malignant giant cells in a young female under age 30. The malignant tumors were found in both breasts; the first one was diagnosed when the patient was 23 years of age and the second one in the contralateral breast four years later. Based on our present findings, and in keeping with a similar case recently described by us as occurring in an elderly female, we thought that the bizarre giant cells in this rare breast carcinoma were of epithelial origin. The differential diagnosis of other conditions that may be associated with giant cells in breast aspirates is discussed.