{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:50:00Z","timestamp":1790311800769,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Breast reconstruction is highly complex, requiring navigation of not only clinical and operative realities, but of patient expectations as well. The authors sought to identify historical art pieces that exhibit breast asymmetries and deformities for comparison with photographs of breast reconstruction patients seen at the clinic of the senior author (S.O.P.) to demonstrate that achievement of perfect breast cosmesis is challenging in both breast reconstruction and in the classical arts. Open access libraries and Creative Commons images were reviewed to identify appropriate works of art from various time periods and geographic locations. Following artwork selection, photographs of breast reconstruction patients were reviewed and paired with selected artworks exhibiting cosmetically similar breasts. A total of 8 pieces of selected historic art were found to have at least 1 matching patient photograph, with 9 correlative patient photographs ultimately chosen. Common breast asymmetries and deformities identified included ptosis, asymmetric chest wall placement, asymmetric nipple placement, and absence of the nipple. This review identified diverse artworks of varying styles spanning vast expanses of both geography and time that exhibited breast deformities and asymmetries commonly encountered in patients seeking revision of breast reconstruction. This underscores that creating the cosmetically ideal breast is difficult both in the operating room and the art studio. Importantly, the authors emphasized that the arts frequently celebrate that which is considered beautiful, although to the trained eye of a plastic surgeon that which is considered beautiful is often classified as dysmorphic or asymmetric.<\/jats:p>","DOI":"10.1093\/asj\/sjae029","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T22:51:38Z","timestamp":1707259898000},"page":"716-721","source":"Crossref","is-referenced-by-count":3,"title":["From Tip of Brush to Tip of Knife: The Relationship Between Post-mastectomy Breast Reconstruction and the Classical Arts"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2384-9210","authenticated-orcid":false,"given":"Kasey Leigh","family":"Wood Matabele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeeda H","family":"Nkana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison J","family":"Seitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-6581","authenticated-orcid":false,"given":"Armin","family":"Edalatpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish Y","family":"Mahajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel O","family":"Poore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"issue":"2","key":"2024061413430066800_sjae029-B1","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/00006534-199708000-00032","article-title":"Anthropomorphic breast measurement: protocol and results in 50 women with aesthetically perfect breasts and clinical application","volume":"100","author":"Westreich","year":"1997","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"2024061413430066800_sjae029-B2","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.cps.2015.06.012","article-title":"Shapes, proportions, and variations in breast aesthetic ideals: the definition of breast beauty, analysis, and surgical practice","volume":"42","author":"Mallucci","year":"2015","journal-title":"Clin Plast Surg"},{"issue":"5","key":"2024061413430066800_sjae029-B3","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s00266-018-1154-6","article-title":"Metrics of the aesthetically perfect breast","volume":"42","author":"Atiye","year":"2018","journal-title":"Aesthetic Plast Surg"},{"issue":"2","key":"2024061413430066800_sjae029-B4","doi-asserted-by":"publisher","first-page":"226","DOI":"10.5999\/aps.2015.42.2.226","article-title":"A consideration of breast imagery in art as depicted through western painting","volume":"42","author":"Hwang","year":"2015","journal-title":"Arch Plast Surg"},{"issue":"6","key":"2024061413430066800_sjae029-B5","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1097\/PRS.0000000000006225","article-title":"Elective revisions after breast reconstruction: results from the mastectomy reconstruction outcomes consortium","volume":"144","author":"Nelson","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"2024061413430066800_sjae029-B6","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1177\/1090820X11410868","article-title":"Incidence of breast and chest wall asymmetries: 4D photography","volume":"31","author":"Gabriel","year":"2011","journal-title":"Aesthet Surg J"},{"issue":"7","key":"2024061413430066800_sjae029-B7","doi-asserted-by":"publisher","first-page":"e2297","DOI":"10.1097\/GOX.0000000000002297","article-title":"Natural breast symmetry in preoperative breast cancer patients","volume":"7","author":"Cheong","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"6","key":"2024061413430066800_sjae029-B8","doi-asserted-by":"publisher","first-page":"706","DOI":"10.21037\/gs.2017.06.01","article-title":"Enhancing breast projection in autologous reconstruction using the St Andrew\u2019s coning technique and 3D volumetric analysis","volume":"6","author":"Chae","year":"2017","journal-title":"Gland Surg"},{"issue":"2","key":"2024061413430066800_sjae029-B9","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1097\/PRS.0b013e3181954cc1","article-title":"Shaping the breast in aesthetic and reconstructive breast surgery: an easy three-step principle","volume":"123","author":"Blondeel","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"2024061413430066800_sjae029-B10","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jpra.2020.07.003","article-title":"Shaping of the abdominal flap in breast reconstruction: the coning technique in muscle sparing TRAM","volume":"25","author":"Rutherford","year":"2020","journal-title":"JPRAS Open"},{"issue":"9","key":"2024061413430066800_sjae029-B11","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1016\/j.bjps.2015.04.026","article-title":"Optimizing shape and projection in low-volume bilateral microvascular breast reconstruction: technical tips","volume":"68","author":"Senchenkov","year":"2015","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2024061413430066800_sjae029-B12"},{"key":"2024061413430066800_sjae029-B13","volume-title":"Culture and Values: A Survey of the Humanities","author":"Cunningham","year":"2006","edition":"6th ed"},{"issue":"6","key":"2024061413430066800_sjae029-B14","doi-asserted-by":"publisher","first-page":"296","DOI":"10.3390\/medicina56060296","article-title":"Nipple\u2013areola complex reconstruction","volume":"56","author":"Sisti","year":"2020","journal-title":"Medicina (Lithuania)"},{"issue":"4","key":"2024061413430066800_sjae029-B15","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.ejso.2016.01.003","article-title":"Nipple-areola complex reconstruction techniques: a literature review","volume":"42","author":"Sisti","year":"2016","journal-title":"Eur J Surg Oncol"},{"issue":"3","key":"2024061413430066800_sjae029-B16","doi-asserted-by":"publisher","first-page":"404e","DOI":"10.1097\/PRS.0000000000004166","article-title":"Nipple-areola complex reconstruction","volume":"141","author":"Gougoutas","year":"2018","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"2024061413430066800_sjae029-B17","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1097\/SAP.0b013e318276dac0","article-title":"Single-stage nipple-areolar complex reconstruction technique, outcomes, and patient satisfaction","volume":"73","author":"Liliav","year":"2014","journal-title":"Ann Plast Surg"},{"issue":"5","key":"2024061413430066800_sjae029-B18","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/SAP.0000000000001337","article-title":"Secondary mastopexy after nipple-sparing mastectomy and staged subcutaneous expander\/implant reconstruction","volume":"80","author":"Salibian","year":"2018","journal-title":"Ann Plast Surg"},{"key":"2024061413430066800_sjae029-B19"},{"key":"2024061413430066800_sjae029-B20"},{"key":"2024061413430066800_sjae029-B21"},{"key":"2024061413430066800_sjae029-B22","doi-asserted-by":"publisher","first-page":"702816","DOI":"10.3389\/fpsyg.2021.702816","article-title":"Goldilocks principle: preference for change in breast size in breast cancer reconstruction patients","volume":"12","author":"Nicklaus","year":"2021","journal-title":"Front Psychol"},{"issue":"1","key":"2024061413430066800_sjae029-B23","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1097\/PRS.0b013e3182910b0a","article-title":"A process for quantifying aesthetic and functional breast surgery: I. Quantifying optimal nipple position and vertical and horizontal skin excess for mastopexy and breast reduction","volume":"132","author":"Tebbetts","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"2024061413430066800_sjae029-B24","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.bjps.2011.08.006","article-title":"Concepts in aesthetic breast dimensions: analysis of the ideal breast","volume":"65","author":"Mallucci","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"6","key":"2024061413430066800_sjae029-B25","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1097\/PRS.0b013e3181ccdb97","article-title":"The three breast dimensions: analysis and effecting change","volume":"125","author":"Hall-Findlay","year":"2010","journal-title":"Plast Reconstr Surg"},{"issue":"6","key":"2024061413430066800_sjae029-B26","doi-asserted-by":"publisher","first-page":"e3640","DOI":"10.1097\/GOX.0000000000003640","article-title":"Systematic approach for management and prevention of boxy breast","volume":"9","author":"Abdelkader","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"3","key":"2024061413430066800_sjae029-B27","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1002\/pon.4586","article-title":"Body image dissatisfaction in patients undergoing breast reconstruction: examining the roles of breast symmetry and appearance investment","volume":"27","author":"Teo","year":"2018","journal-title":"Psychooncology"},{"key":"2024061413430066800_sjae029-B28"},{"key":"2024061413430066800_sjae029-B29"},{"key":"2024061413430066800_sjae029-B30"},{"key":"2024061413430066800_sjae029-B31"},{"issue":"2","key":"2024061413430066800_sjae029-B32","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/S1470-2045(18)30035-4","article-title":"Earliest evidence of malignant breast cancer in Renaissance paintings","volume":"19","author":"Bianucci","year":"2018","journal-title":"Lancet Oncol"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjae029\/57144323\/sjae029.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/44\/7\/716\/58230765\/sjae029.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/44\/7\/716\/58230765\/sjae029.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T14:46:23Z","timestamp":1718376383000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/44\/7\/716\/7602583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,7]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,2,7]]},"published-print":{"date-parts":[[2024,6,14]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjae029","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,7]]},"published":{"date-parts":[[2024,2,7]]}}}