People from different demographic backgrounds tend to agree on what they consider attractive when it comes to breast aesthetics, according to a new study published in the Journal of Plastic, Reconstructive & Aesthetic Surgery. While small differences were observed based on gender, sexual orientation, and race, the patterns of preference were strongly correlated across all groups, suggesting some consistency in aesthetic judgments.
The study was designed to explore how different demographic groups perceive breast attractiveness. In recent years, there has been growing awareness that aesthetic ideals may not be universally held, and that factors like race, gender identity, and sexual orientation can shape beauty standards.
In plastic and reconstructive surgery, understanding these nuances has become increasingly important, especially when guiding patients through aesthetic decisions. While earlier work has proposed objective formulas for the “ideal” breast, such as certain volume ratios or nipple positions, this study asked whether preferences really are shared equally across groups.
To answer this question, the research team assembled a set of 25 pre-surgical photographs of patients who had presented for breast surgery at a plastic surgery clinic. These photographs, taken from a front-facing view and cropped to focus only on the torso area, included a diverse range of breast sizes, shapes, skin tones, and nipple-areola configurations. Patients had not undergone prior breast procedures, and all had given consent for their images to be used in de-identified research. About half of the patients were White or Caucasian, with others identifying as Asian, Black or African American, or Hispanic.
The researchers then created an online survey using the Qualtrics platform, distributing the images to a demographically representative sample of the United States population. Participants were asked to rate each pair of breasts on a five-point Likert scale, ranging from “least attractive” to “most attractive.” In addition to these ratings, respondents provided demographic information, including their sex, gender identity, race, and sexual orientation. In total, 1,021 people completed the survey, with a nearly even split between men and women.
The findings revealed several patterns. On average, male participants rated breasts as more attractive than female participants did, giving an average rating of 2.8 compared to 2.5 on the five-point scale. Although men gave higher scores overall, their preferences were still strongly correlated with those of women. In other words, both sexes tended to agree on which breasts were more or less attractive, even if men were more generous with their scores.
A similar pattern appeared when analyzing responses based on sexual orientation. People who reported being attracted to women gave higher ratings across the board than those attracted only to men. Those who were attracted to both men and women gave ratings comparable to respondents attracted only to women and significantly higher than those only attracted to men. This suggests that attraction to women may increase the perceived attractiveness of female breasts, regardless of the rater’s own gender.
Racial differences in ratings were more complex. White or Caucasian respondents gave higher average ratings than Asian respondents, with scores of 2.7 and 2.2 respectively. However, the difference between White and Black or African American respondents was not statistically significant. Importantly, across all racial groups, the relative rankings of breast attractiveness were highly correlated. That means that even when one group tended to give lower average ratings, they still agreed with others on which images were more or less attractive.
The study also explored whether people rated breasts from their own racial group more favorably than others. There was no evidence for this kind of in-group bias. For example, White respondents did not give higher ratings to breasts from White patients, nor did Black or Asian respondents favor patients from their own racial group. Three of the five highest-rated breasts belonged to White or Caucasian patients, while one came from a Black or African American patient and one from an Asian patient. This finding suggests that skin tone alone did not drive differences in ratings, although the researchers noted that respondents could still visually perceive differences in skin color in the photographs.
Although the study provides new insight into how people perceive breast aesthetics, it does have several limitations. The sample of photographed patients was relatively small and not fully representative of the racial and ethnic diversity found across the United States. All images came from individuals who visited the same surgeon, and the final selection was made by that surgeon, potentially introducing bias into the photo set.
Another important consideration is that survey participants were not asked why they rated breasts the way they did. Future studies could explore the reasoning behind individual ratings, perhaps by asking participants to comment on specific features like nipple position, breast symmetry, or fullness of the upper and lower pole. New technologies, such as artificial intelligence-generated imagery, might also help future research isolate variables more effectively by creating standardized images that differ in only one feature at a time.
Despite these caveats, the findings suggest that personal identity plays a role in shaping aesthetic preferences. While demographic groups may show different average preferences, the high correlations between them indicate broad agreement on the relative appeal of different breast appearances.
The study, “Differential preferences in breast aesthetics by self-identified demographics assessed on a national survey,” was authored by Carter J. Boyd, Jonathan M. Bekisz, Kshipra Hemal, Thomas J. Sorenson, and Nolan S. Karp.