We read with interest this paper defining the ideal breast dimensions as a 45:55 ratio of upper to lower pole proportions.1 Whilst we commend the authors for attempting to tackle such a difficult problem we are however unsure if the proposed methodology is suitable or sound.One of our principal concerns is a point that the authors partially refer to in that the photographs analysed are not standardised. The models are typically posing with arched backs, retracted shoulders with variable arm positions, presumably to accentuate breast projection. Comparison between such images with clinical photographs is not possible with any degree of accuracy2'3 especially as images in journals are themselves easily misinterpreted.4 For example, differences in positioning of the camera can change the apparent relationship between the nipple and inframammary fold.
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