Applanation tonometry for the evaluation of breast compressibility.

Capsular contracture is the main problem following breast augmentation with silicone implants. Subjective assessment has been the predominant method for evaluating breast firmness hitherto, although several objective methods have been described. In this prospective study applanation tonometry was used on 76 women following augmentation mammaplasty. Breast firmness was measured five times during the first postoperative year. Approximation of the breast imprint area to an ellipse was shown to be accurate and to simplify the estimation of the applanation surface, which is proportional to breast compressibility. The results correlated well with the subjective assessments using the Breast Augmentation Classification (BAC). A classification based on applanation tonometry is presented.