Plastic and
Reconstructive Surgery June 2016 -
Volume 137 - Issue 6 - p 1728–1737
Mallucci,
P. Branford, O
Background: The authors’ published studies have helped
define breast beauty in outlining key parameters that contribute to breast
attractiveness. The “ICE” principle puts design into practice. It is a
simplified formula for inframammary fold incision planning as part of the
process for determining implant selection and placement to reproduce the 45:55
ratio previously described as fundamental to natural breast appearance. The
formula is as follows: implant dimensions (I) − capacity of the breast (C) =
excess tissue required (E). The aim of this study was to test the accuracy of
the ICE principle for producing consistent natural beautiful results in breast
augmentation. Methods: A prospective analysis of 50 consecutive women
undergoing primary breast augmentation by means of an inframammary fold
incision with anatomical or round implants was performed. The ICE principle was
applied to all cases to determine implant selection, placement, and incision
position. Changes in parameters between preoperative and postoperative digital
clinical photographs were analyzed. Results: The mean upper pole–to–lower pole
ratio changed from 52:48 preoperatively to 45:55 postoperatively (p < 0.0001).
Mean nipple angulation was also statistically significantly elevated from 11
degrees to 19 degrees skyward (p ≤ 0.0005). Accuracy of incision placement in
the fold was 99.7 percent on the right and 99.6 percent on the left, with a
standard error of only 0.2 percent. There was a reduction in variability for
all key parameters. Conclusion: The authors have shown using the simple ICE
principle for surgical planning in breast augmentation that attractive natural
breasts may be achieved consistently and with precision
