May One-Cup-Size Increase Be Used as the Clinical Reference?

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Drs. King et al. (Plast Reconstr Surg. 2017;139:1084–1089) are to be commended, as they invented a novel method that used computed tomographic technique to reconstruct the bra’s three-dimensional digital images and then to measure the bra volume.1 In addition, they denied the traditional report and updated it into “the average increase was above 100 cc.” We agree fully with the authors that this method is more accurate than the other two methods and appreciate the remarkable innovation, which demonstrated that the interval increase varied among different sizes and brands dramatically, ranging from 87 to 230 cc.
However, we take the conclusion that “130 to 150 cc equates to a one-cup-size increase” with some reservations. Not only the statistical analysis but also the market share aroused our curiosity. In the laboratory arm, the brand and style of bra were fixed, which limited the sample capacity. Because all women did not wear exactly the same brand and type as the authors chose, they should have used median instead of mean to represent the interval increase, inasmuch as it varied between bra cup sizes, and the data might not follow a normal distribution.
In my opinion, the one-cup-size increase failed to be the clinical reference that is used to predict the breasts’ postoperative outcome. The bra cup size ranged because of the difference of brands, sizes, and bands.2 To be exact, the conclusion drawn by the author should have been, “Bra cup size has no standardization in the bra manufacturing industry.” Choosing the implant by means of the one-cup-size increase in volume seems fantastic, but may not be realistic.
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