Examination in breast reduction surgery should focus on the following areas:
- general examination:
- size of frame
- proportionate size of torso
- scoliosis
- rib visibility
- chest wall deformities
- previous scars and quality of scarring
- lymphadenopathy
- skin:
- quality eg thickness, elasticity; pinch skin to assess skin thickness
- skin conditions eg eczema
- intertrigo, particularly in the submammary fold
- stretch marks
- guttering of bra straps into shoulders
- nipple/areola complex (NAC):
- nipple:
- areola:
- position of NAC in relation to inframmary fold - degree of ptosis of NAC
- symmetry of NAC's
- breast mound:
- size of breast
- symmetry
- position of breast volume on chest wall and within skin envelope - degree of ptosis of gland (Regnault's classification of breast ptosis)
- axillary tail prominence
- masses
For planning breast reduction surgery, the following measurements are vital:
- chest circumference for assessing breast and bra sizing:
- at level of maximum breast projection
- at level of inframammary fold
- nipple distance to sternal notch
- inter-nipple distance
- nipple distance to inframammary fold