Purpose: When performing modern breast surgery, target measurements are commonly used which were developed in another era. We seek to define the modern ideal aesthetic breast. Additionally, we are interested in interobserver variability by observer background and the effect of breast augmentation on breast aesthetics.

Methods: In fifty female volunteers, multiple anthropomorphic measurements were taken. From these a subgroup of ten women with similar body types were selected. Another patient who underwent breast augmentation was added in with her preoperative photos serving as a control, for a total of twelve patient photo sets. These were shown to two groups of examiners who were either plastic surgeons or community women. Each examiner rank-ordered the photos according to aesthetics.

Results: There was relatively little intergroup variability for the two examiner groups. The more aesthetic breasts, when compared to historic data, had similar sternal notch-to-nipple but slightly increased nipple-to-IMF distances. The patient who had undergone breast augmentation scored significantly higher post-augmentation. There was a trend for women tolerating more ptosis than the surgeons.

Conclusion: The aesthetics of the ideal breast have evolved. Plastic surgeons and community women have generally similar ideas toward breast aesthetics. Breast augmentation may significantly improve breast aesthetics.