23 ms·

Improving breast reconstruction surgery with a web-based survey

109 points by magnusbaringer 6y ago

revicon 6y ago
I tried, I really did, but this survey takes forever to load each photo. I finally gave up.
- Rick1 6y ago
  Indeed. The loading time far exceeds the time I spend actually making choices.
- tait 6y ago
  Same here - any chance on getting it to pre-load or something?
- magnusbaringer 6y ago
  Thank you so much for your time, effort and support. I am very sorry for the inconvenience. I checked the server multiple times - despite the unexpected huge amount of traffic from HN the server still seems to be fine. So I am not sure what causes these long loading times for some participants. I am very sorry for that - I will try to my best to improve this somehow. Thank you again for your support!
  - XCSme 6y ago
    I can confirm, it takes like 1-2 minutes for each new question to load on a very good internet connection (from EU).
    - magnusbaringer 6y ago
      Thank you very much for this feedback. I will try my best to improve that!
    - magnusbaringer 6y ago
      Just a quick update: I have improved the code and think that I thereby was able to reduce loading times significantly. Thank you for your effort and patience - it really means a lot!
  - gus_massa 6y ago
    Is the server in the university/hospital and are you testing from the same building? Try testing from your home or as fas as possible. Also use another browser, so the images are not in the cache or something.
    - magnusbaringer 6y ago
      Thank you very much for your feedback and support! I already tested it from a "remote" location. I have optimized the code tonight and think I was able to improve performance significantly! I am very sorry for the inconvenience - but I never expected that amount of traffic on the site, so I was a little bit overwhelmed by that :-) But I hope that the issue is improved now!
- xx__yy 6y ago
  Is it actually a study on human behavior?
  - magnusbaringer 6y ago
    Thank you for your interest and feedback. Yes - in some ways it is. We want to get a far more profound understanding of the influence the different parameters (e.g. size, shape, areola sizes, areola positions etc.) have on the aesthetic perception of the female breast. So in the end we would love to get results like: in case of a areola asymmetry, more people tend to accept a asymmetry than a correction when you therefore have scars. I hope that explanation helps a little bit. Thank you for your time and support.
Rick1 6y ago
Slow loading times aside, looks well made.
- magnusbaringer 6y ago
  Thank you very much for the kind feedback and your support! I will try my best to improve the loading times.
- magnusbaringer 6y ago
  Just a quick update: I hope to have improved loading times significantly with some code improvements. Thank you for your support!
DoreenMichele 6y ago
The landing page is safe for work. The survey itself involves looking at bare breasts, so is "NSFW." Breast cancer runs in my family. Two close relatives have had it more than once starting at early ages. My impression is you are barking up the wrong tree. What is "aesthetically pleasing" to random strangers according to some survey is of little importance. If she is in a serious committed relationship, her partner's opinions will be really important to her decision-making process. If she is really young, this will tend to matter a lot more to her than if she is older. Scarring is not just about aesthetics. It's about pain and swelling and limited movement and things like that. That tends to get short shrift by people in the business of selling you surgery for the purpose of improving your appearance. I started the survey but didn't finish it. It's boring and repetitive and I thought images were weird, starting with the detail that there are no arms. Like I'm supposed to care about a woman's breasts and not be bothered by the fact that she has no arms? As a woman who gets tired of some people acting like I am only a sex object and the only parts of me that matter are the parts covered by a bikini and as someone with a serious disability, I find details like that pretty insensitive and disturbing.
- Rick1 6y ago
  > What is "aesthetically pleasing" to random strangers according to some survey is of little importance. It's extremely important to most people. We go out of our way to look good. Just look at any shopping street. Clothes, makeup, gyms, etc.
  - parineum 6y ago
    The goal of not caring what other people think about your physical appearance is noble but naive and I'm not even really certain it's ideal. It's definitely something that people say in situations like this but if you'd ask literally anybody who's had a mastectomy if they could keep their breasts looking exactly the same before surgery as they did before, I guarantee that nearly all of them would want that. I think it's much more important to help people be confident in themselves with their new appearance than it is to tell them they are just the same as they were before. I think it's misguided to try and convince people that they didn't lose something.
deleted 6y ago
[deleted]
julienreszka 6y ago
why is it loading so slowly
conductr 6y ago
I took the survey. I see the value in this. Simply because aesthetics are important (big concern for patient) and maybe you could use data to help them make a big decision in a data driven way on which type of surgery to choose. As with other surveys like this, and perhaps eye exams, I found myself several times thinking "these two look the same", or "I have no obvious preference", or "I like both". I'm bringing it up because I think that's valuable data that should be considered.
- magnusbaringer 6y ago
  Thank you very much for your time taking part in the survey and your great feedback. That is exactly our goal - to help patients with decision making. Patients often are quite unsure about what is the aesthetically best option for them and want to know what people prefer in general - and the least we should be able to do for patients is give the good and research-backed advice. We know that some picture combinations look very similar - however there are no duplicates in the survey. However of course, sometimes it is quite difficult to make a decision. But we also measure the time of every decision - so in the end we will be able to tell which aspects are quite obvious and therefore quick and easy to decide - and which are not. Thank you for your support!
  - conductr 6y ago
    Good to hear you thought of it, I would say that due to load time, the response measure should be suspect. Using myself as an example, I clicked, read some news, came back and clicked, go get a drink, etc. Took me over an hour to finish.
    - magnusbaringer 6y ago
      Really? I am super sorry for that inconvenience - and even more thankful that you took the time to finish despite these enormous loading times. I will try my best to improve that! Thank you so much for that feedback!
      - 6y ago
ampdepolymerase 6y ago
Unrelated but which library did you use for the loading spinner? It is the exact same widget as the one used by the new Medium site.
- magnusbaringer 6y ago
  Thank you for your comment. I have used this spinner for 5 or 6 years already. It is just a GIF - to be honest I can't remember where I got it from back then.
nacs 6y ago
After I answer a question, it goes back to the "Start the survey" screen every time (browser: Firefox v83)
- givehimagun 6y ago
  Firefox v82 here and mine worked...except there were long wait times between images.
- magnusbaringer 6y ago
  Thank you for your interest and taking the time. Did you select a gender and age group? If one of those selections is not selected, you will be taken back to the landing page. Could this maybe cause the problem? Thank you for your support!
  - alisonkisk 6y ago
    Yes, but you should change the website to block before the survey starts, instead of just being broken. Also, your data set is likely to be overwhelmed by foods and trolls. Good luck.
roel_v 6y ago
Very cool research. I'm sure there are lots of people on here who would love an in-depth write up of how you construct these images.
- magnusbaringer 6y ago
  Thank you so much for this kind feedback! To be honest I am completely overwhelmed by the amount of responses and feedback - I never expected that. I will happily put together more in-depth information about how the project came to life and how everything works! I just have to try to keep up with all comments and responses first :-) Thank you for your support!
  - roel_v 6y ago
    Oh I'm sure nobody expects you to write anything up tonight :) After getting along a bit further in the survey, I'm also interested in how you're going to approach the analysis of the responses, more specifically, how you're going to separate out the personal preferences of respondents, since I've had a few cases now where the choice was basically "do I find large breasts more attractive than smaller ones" - even if there were some minor other factors at play in the specific images. Anyway, good luck, although I do agree with some other posters that you might get more people to complete the whole thing if you'd show them fewer images; it takes a long time to get through a full round.
adzm 6y ago
Will this data be available publicly? Also are the images tagged with metadata about measurements?
- magnusbaringer 6y ago
  Thank you for your comment and interest! We will definately publish all data - after all we want to help patients and surgeons so we have to get all the data out to them! At the moment we are just a little bit overwhelmed by the amount of feedback and participants to be honest :-) But of course all data will be published! We have an email subscription box at the end of the survey - we will notify everyone who is interested as soon as we publish the data. What exactly do you mean with metadata and measurements? Do you mean the breast sizes? The breast conditions are rendered from 3D-measured breasts of real patients - so the displayed conditions and breast sizes are completely based on real measurements and the corresponding measures (e.g. cup-size).
brian_c 6y ago
Disappointing that all the images are built on the same shade of white skin. You're leaving out a whole lot of folks who are already underrepresented in a whole lot of research. I think it'd be helpful to vary the skin tones shown, or stick to a medium-tone (enough to be ambiguous) grayscale.
- magnusbaringer 6y ago
  Thank you very much for your feedback and time! We know that we do not cover aspects like skin tone - and we would love to somehow implement that. The problem is that to get the best statistical results, the "decision-influencing" differences between images ideally have to be reduced to just the exact condition (e.g. different breast size). Every other additional variation (e.g. skin tone) would "blur" the data. As we need 88 picture pairs to cover all required breast conditions anyways, it is practically impossible to take any other aspects into the survey (e.g. skin tone) without completely exploding the number of pictures and blurring the data. So we apologize for that "inconvenience" - but we haven't found a better solution. Thank you very much for your support and feedback!
  - shigawire 6y ago
    Maybe that could be a selection criteria at the start? If you add 5 skin tones doesn't that only x5 the number of images?
  - waterhouse 6y ago
    I wouldn't even call it white skin, actually. It's not really a flesh color; breaking out the Digital Color Meter, it's slightly warmer than a grey. Then there's the way light reflects off of it, some of it looking rough or dirty in a way skin usually doesn't, with some parts brightly lit as if by one very bright source. (I think glare explains some of it.) The breasts themselves often look brighter, and sometimes cleaner, than everything else; occasionally they do match the surrounding skin, which naively looks a lot better until I realize I have to abstract out the lighting. Even if you can't vary the skin tones, I think that using more uniform lighting would help. And maybe something dumb like spraypainting the main body a mono-color would work, although that might make it more complex to show scars.
Raphmedia 6y ago
I am part of the transgender demographic. Thank you for your work, for us it is life saving. A lot of trans people can only afford one surgery in their life time and so many complain of having received poor results. I hope your dataset improves the results of everyone, everywhere!
- magnusbaringer 6y ago
  Thank you so much for your support and this kind feedback! We will do our best - and if only one surgery can be improved, we already helped one patient to get a better result than otherwise. Thank you for your time and support!
wolverine876 6y ago
I expect the following is not novel to you, but would you share how you address it with your patients and in this study? In my experience - not based on professional expertise - when people are very concerned about what others will think, in regard to any topic, it is due to a lack of self-worth or self-understanding. They want others to fill that hole, to provide the answer or esteem that they have trouble providing to themselves; they put enormous power in others' opinions. The solution is not to talk about what others think but to find help them find those things within themselves - how do they feel about their choice, their action, their physical being. This study (which I understand might represent only one aspect of your strategy with patients) focuses only on what others think as an answer to the patients' uncertainty. It seems to assume that the worth of the patients' own bodies depends on pleasing others, that the value of this body part is as objects of pleasure for others. And of course we know well that our society sends that message to women, about this body party in particular, very often. And to avoid any misunderstanding, I'm not setting up some argumentative binary concept that people don't care at all how they look. To varying degrees, everyone cares. But I worry far more about the self-esteem and emotional health of the patients than I do about how their breasts look (Edit: And I assume you do too and are acting in good faith). For their breasts, the only person to please is themselves.
- wolverine876 6y ago
  Mods - I'm almost certain I posted the above as a reply to the original top post: https://news.ycombinator.com/item?id=25169521 https://news.ycombinator.com/item?id=25169521 What happened?
  - nickff 6y ago
    Your comment probably got split off because it was not a reply to the OP's comment, it was a general commentary on the topic.
    - wolverine876 6y ago
      Hmmm ... I haven't seen much of that happening on HN. People respond to the top comment all the time. Also, it was a direct question to the person who posted the top comment, not a commentary.
magnusbaringer 6y ago
Dear HN-Community, First of all I want to thank you all very much for all this wonderful support, kind feedback and overall interest in the study. I am completely overwhelmed by the amount of responses and interest. I try my best to keep up with all comments and feedback. It is nearly 23:00 o'clock here in Germany and I had a day full of surgeries - and my schedule for tomorrow is packed as well. So please forgive me if I have to grab a few hours of sleep and may not be able to answer all questions immediately. I will do my best to keep up with everything as good as possible! Just a few additional information in general in response to some frequently asked questions. The goal of this study is to get a more profound understanding of what aspects and factors of the female breast in connection with breast surgeries are being percieved as aesthetically pleasing. Why is this so important? Of course we know that beauty is in the eye of the beholder - and surgery decisions are not based on aesthetics alone. But believe it or not - in the majority of cases patients are overwhelmed by taking decisions regarding the surgery of their own breast. Especially in case of breast cancer, the situation is so difficult and live changing for patients, that it's super difficult to take clear decisions or even just focus on own preferences. Other obvious factors like medical aspects or potential pain aside - for many patients it is extremely important to get profound pre-operative advice on what "generally" is seen as "aesthetically pleasing". E.g. do people like it more if there is a slight asymmetry after breast reconstruction - or is it better to do a correction but therefore have scars. There are many decisions that have to be taken - and for most patients it is very helpful to get good advice. Of course there are patients that know exactly what they want - and what their preferences are. However - as strange is this might sound - for the majority of patients that is not the case. The goal of this study is to get a better understanding of what factors and aspects of the female breast and surgery conditions do have an influence of the aesthetic perception. The survey contains 88 picture pairs - no pair is equal (although some look quite similar). The order of the pictures is being randomized for every participant. The number of 88 pictures is the minimum number that we need to cover every possible "real-life" condition of a breast to get enable a profound statistical analysis. Some pictures might seem similar to you - but your decision allows us to gather a lot of data about why you took that decision and thereby better understand what factors really have an influence. In the end, we hope to find out what aspects do matter more than others - in order to then be able to give patients better advice (e.g. scars are percieved as more aesthetical than an asymmetry if the asymmetry is just one cup size). We know that this study is not perfect - but as far is we know it is by far the most sophisticated study in this area so far. Therefore we hope that we can maybe gather new helpful data. And if only one surgery can be improved, we already helped one patient to get a better result than otherwise. Therefore, thank you all very much for your support and time! I will do my best to reply to every comment and feedback! Thank you, Magnus
loceng 6y ago
May it be worth having another question before survey starts: when was the survey taker last sexually active (to orgasm) to see how/if selection changes?
- magnusbaringer 6y ago
  Thank you for your support and interest in the project - and of course this thoughtful input. We have had hours of discussions on how many "metadata" we ask for. The two main reasons for the fact that we decided on just gender and age are on the one hand the more data you ask for, the less people will take the time and effort to start the survey (so we wanted to make the "barrier" for participation as minimal as possible). On the other hand, this study has been designed completely in alignment to approvals by the ethics committee of our university and they demanded us to gather as little as possible "personal" data of the participants. I hope that explanation helps a little bit. Thank you for your support!
  - loceng 6y ago
    Understandable but I'd argue that it's quite an important attribute - as it's known that post orgasm people's sexual drive/interest is/can be greatly reduced - and therefore what is stimulating will be different. I'd highly recommend having that additional field (that isn't personally identifying data either which is where I assume the concern is) if you run this experiment again - which I hope you do with better load times, things like different torso sizes - as proportion of breasts to torso size has an impact, etc. Still kudos to you for the work.
thaumaturgy 6y ago
FWIW there's a subreddit community dedicated to "ideal" breast shape, which they explain in a pinned post: https://old.reddit.com/r/fortyfivefiftyfive/comments/ark20j/this_should_be_a_sticky/ https://old.reddit.com/r/fortyfivefiftyfive/comments/ark20j/... (NSFW; the community is for porn and the top of the is full of their favorite images). The pinned post cites another study. It looks like you're trying to evaluate the importance of a lot more details than that, and I'd be shocked if you weren't already aware of that study, but there it is just in case.
- deleted 6y ago
  [deleted]
- magnusbaringer 6y ago
  Thank you very much for your interest and support! In deed we were already aware of this study. However we want to get a far more profound understanding of the influence different parameters have on the breast. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So results of the study will be something like: in case of an areola size asymmetry, more people tend to accept the asymmetry then a size correction when you therefore have scars. I hope that explanation helps a little bit! Thank you very much again for your support!
wolverine876 6y ago
Magnus - We're not raising simplistic issues about whether beauty is in the eye of the beholder, but addressing how those women are best helped. It's indeed heart-breaking to hear how difficult the situation is. For example, when they are overwhelmed with the decision, terrified about what everyone else will think, then perhaps a mental health professional would be the better option to help them through it then someone with authority (the surgeon) reinforcing to them, with research, that everyone else's opinions are essential. Edit: I'm not sure that's what's going on, but I think it's a reasonable concern about the survey and how it will be used. I'm posting this because the two questions below about this issue didn't receive responses and the way the issue is addressed above seems to possibly trivialize the questions, but that could be unintended or a language issue. Sorry if I'm misunderstanding you.
- nickff 6y ago
  You're asserting that people who have suffered cancer and a very invasive (likely traumatic) operation probably have mental health issues as well? I'm all for people consulting counselors and psychologists, but many people want to get back to normal, and part of that is to look the same as they did before, and avoid others asking them very personal questions or making hurtful comments. The doctors performing reconstructive surgeries are not taking advantage of vulnerable individuals, they are helping support people's recoveries.
  - wolverine876 6y ago
    > I'm all for people consulting counselors and psychologists, but many people want to get back to normal, and part of that is to look the same as they did before, and avoid others asking them very personal questions or making hurtful comments. The doctors performing reconstructive surgery are not taking advantage of vulnerable individuals, they are helping support people's recoveries. I'm not sure I understand ... ? First, I certainly didn't say that the doctors are taking advantage of anyone and certainly don't think so! I don't even know what ulterior motive the doctors would have. Please don't attribute things to me. The job of mental health professionals is to help the patient achieve whatever their goal is, whether that's 'getting back to normal' or to help with a difficult decision or situation. Who are you saying would be "asking very personal questions and making hurtful comments"? Mental health professionals? Mental health treatment is not an inquisition; there's no judgment made. Just like the surgeon, their job is to help the patient. ---- The doctors have asked us to take a survey. It's reasonable to raise legitimate concerns about that survey; we're not and shouldn't be thoughtless and unskeptical.
boobybomb 6y ago
Technology gone berserk.
- dang 6y ago
  Creating accounts to break HN's guidelines with will eventually get your main account banned as well, so please don't do that. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
haram_masala 6y ago
This reminds me of a optometrist exam. And, gives me an idea for an improved version of one.
darig 6y ago
This study seems biased to always select reconstruction. Why isn't there an option showing no reconstruction, or an option to say neither reconstruction is aesthetically pleasing?
- magnusbaringer 6y ago
  Thank you very much for your interest in the study and your feedback! I do understand where your concern comes from. However, in the statistical analysis of the data we do not look at the "complete" breast images. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So the result of the study will not be "reconstruction is preferred". Instead we want to get a far more profound understanding of the influence the different parameters have on the breast. So results of the study will be something like: in case of an areola size asymmetry, more people tend to accept the asymmetry then a size correction when you therefore have scars. I hope that explanation helps a little bit! Thank you very much again for your support!
  - darig 6y ago
    I have a degree in mathematics, so you don't need to explain statistical analysis to me. That would be as ludicrous as me pointing out to a medical doctor what a control group is... but here we are.
magnusbaringer 6y ago
Dear HN-Community, Just a quick update after a very short night :-) Thank you so much for all the support, wonderful feedback and of course the time you take for this project! If just improved the code - so I hope that loading times are reduced significantly now! I apologize to all who have taken the survey so far despite the long loading times - I am very sorry for the inconvenience! Thank you for your effort in supporting this study! I hope the loading time issue is significantly improved now! Greetings from Germany, Magnus
dotancohen 6y ago
> It would be awesome if you would sacrifice > 5 minutes of your time to support this project. Five minutes of looking at breasts for science? I'm willing to make that sacrifice.
- magnusbaringer 6y ago
  Thank you very much for your time and support! It really means a lot!
  - dotancohen 6y ago
    After taking the survey, I must express two things that I've realized during the survey. For one, my personal preference may not be the chest that is "more aesthetically pleasing" even though that is what the survey explicitly asks for. There are considerations other than aesthetics that should be considered. In my opinion, instead of the survey showing two cases (one perfect, one slightly afflicted), the survey should show just the afflicted chest and ask "is this aesthetically pleasing or not". Of course the perfect chest is more pleasing, but that does not mean that there was any problem requiring intervention on the other chest. I've noticed that asymmetry with regards to breast size really are not a problem (for me), even in extreme cases. I've noticed this asymmetry in many women who have not had breast cancer or other afflictions. However, nipple asymmetry does stand out, especially vertical asymmetry. Two nipples at different heights does look terrible, and if aesthetics are an issue then I could understand performing surgery for those cases.
    - magnusbaringer 6y ago
      Thank you very much for your time and support! I do understand your concern - however the data collection works a little bit different "under the surface" as it seems. In the statistical analysis of the data we do not look at the "complete" breast images. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So the result of the study will not be "people like image X more than image Y". Instead we want to get a far more profound understanding of the influence the different parameters have on the perception of the breast. As we also measure the decision time, results of the study will be something like: "most people (or maybe just men - that's what we want to find out) tend to accept breast size asymmetry more then areola asymmetry. The decision happens much faster on areola asymmetries - so that seems to be more obvious and therefore has to be taken more care of during the surgery." Nobody has every done a profound analysis of these individual parameters alone - so that is where we see huge potential for a better understanding. I hope that explanation helps a little bit! Thank you very much again for your support!
magnusbaringer 6y ago
Dear HN-Community, Another quick update. We launched this study not even 1 week ago - with our 4 week goal being 100 participants and our half year goal being 1000 participants. After sharing the study to friends and family, we were already able to reach 1.300 participants within the first 4 days - which was already mindblowing for us and exceeded all our expectations. With 1000 paticipants the data would probably already have been better then most research that has ever been done in this field. Thanks to the support of this unbelievably kind and helpful community we have now reached more than 6100 participants, collected more than 160.000 votes and nearly 800.000 datapoints in our database. The amount of extremely valuable and helpful data is just beyond believe for us - and I cannot thank you all enough for all your support, effort and positive feedback! We are now on the edge of creating one of the most if not the most profound studies in the field of breast surgery ever - and the amount of extremely helpful knowledge we can get from the data is just overwhelming. Thank you HN for this wonderful opportunity, all your support and all your fantastic feedback and kind help!
- jamesiscool 6y ago
  This is awesome, but are you worried that you know what HN readers think about breast reconstruction aesthetics and that that may not exactly match the general population. Guess you can compare it to the first 1,300 responses?
magnusbaringer 6y ago
Dear HN-Community, I know this might be a little different post - but we hope it might be appropriate nevertheless. I am a physician in reconstructive and plastic surgery with a passion for technology. A big part of my job is breast reconstruction (e.g. after breast cancer, malformations etc.). Usually, those surgeries are extremely stressful (and in case of cancer lifechanging) for patients - which makes decision taking very difficult for them in most cases. It is a fundamental part for surgeons to support and accompany patients on their way. Many important decisions have to be taken - by the patient as well as by surgeons. E.g. in case of an asymmetry after breast cancer patients have to decide whether they prefer to live with an asymmetry or an alignment, which, however, leads to scars. As simple as this decision may sound for you - for most patients it is not. Unfortunately, the is no realiable data and research on a larger scale so far, that allows surgeons to better understand what patients (and society in general) accepts as an "aesthetically pleasing" outcome. Therefore I built a web based software, that is able to create relatively realistic models of various breast conditions - e.g. different breast sizes, asymmetries, scares and so on. I then built this software into a survey, that mixes different conditions in a pseudo-random way, that allows us to gather a vast amount of realiable data on a scale that has never been seen in this field of medicine before - which ultimately would significantly improve advice and also surgery for patients. It would be awesome if you would sacrifice 5 minutes of your time to support this project. I am looking forward to answering any questions. Thank you for your time and support.
- danielh 6y ago
  I followed the link before I read your comment. On mobile, I did not notice that there is any scarring or thought it was just rendering artifacts. I would expect your results to be skewed toward the more symmetrical images. Also, is there any reason why the survey takes five minutes? Why not limit it to 10 images, with the option to keep going? I really like the idea, I hope this feedback is valuable.
  - magnusbaringer 6y ago
    Thank you very much for your time and feedback! The scars are indeed not too prominent. In fact we had ours of discussions about the intensity of the scars - in the end we decided to go for a scar intensity that equals the average scar after about 2 years (so they wouldn't be too obvious in reality either). The survey has 88 picture pairs that are mixed randomly. These 88 pairs are the absolute minimum to cover all relevant breast conditions in a way that allows us to get good statistical data. We calculated the average decision time per picture pair with 3 seconds - hence the 5 minutes. However the survey is structured in a way that if a participant only clicks 10 pictures, we can still use the data from those 10 clicks. So every click counts - and if someone is kind enough to click all 88 pictures, we get a full set of data. Thank you very much for your interest and support!
gus_massa 6y ago
Does this need a NSFW tag, for people that live in a silly country? Are the position of the images randomized, or you show always the non-intervention version on the same side? It's a little too long. I'll try to complete it later. The images take too long to load, and you can see how they are constructed. It is slightly weird.
- magnusbaringer 6y ago
  Thank you for your reply and your feedback. I'm not sure about the NSFW tag - however if you select age under 18 you cannot start the survey, so I hope it is ok without the NSFW tag. The order of the images is completely randomized - so the survey is never the same for two participants. The images however follow a complex algorithm - no image pair shows up twice. The number of images - although admittedly quite high - is the absolute minimum amount to simulate every important condition/decision-combination relevant for surgery. The load time was optimized - however depending on your location and server load it might of course be a little to long (I try to further improve that). Thank you very much for your support!
  - gus_massa 6y ago
    How many images are there in total? It looks like the images are generated from smaller parts that are downloaded separately. Perhaps you can download all the parts in hidden images and combine them on demand. Also, perhaps you can render the images in a hidden canvas while the user is selecting the previous pair of images, so when the user makes a click the change has no pause.

revicon 6y ago

I tried, I really did, but this survey takes forever to load each photo. I finally gave up.

Rick1 6y ago
Indeed. The loading time far exceeds the time I spend actually making choices.
tait 6y ago
Same here - any chance on getting it to pre-load or something?
magnusbaringer 6y ago
Thank you so much for your time, effort and support. I am very sorry for the inconvenience. I checked the server multiple times - despite the unexpected huge amount of traffic from HN the server still seems to be fine. So I am not sure what causes these long loading times for some participants. I am very sorry for that - I will try to my best to improve this somehow. Thank you again for your support!
- XCSme 6y ago
  I can confirm, it takes like 1-2 minutes for each new question to load on a very good internet connection (from EU).
  - magnusbaringer 6y ago
    Thank you very much for this feedback. I will try my best to improve that!
  - magnusbaringer 6y ago
    Just a quick update: I have improved the code and think that I thereby was able to reduce loading times significantly. Thank you for your effort and patience - it really means a lot!
- gus_massa 6y ago
  Is the server in the university/hospital and are you testing from the same building? Try testing from your home or as fas as possible. Also use another browser, so the images are not in the cache or something.
  - magnusbaringer 6y ago
    Thank you very much for your feedback and support! I already tested it from a "remote" location. I have optimized the code tonight and think I was able to improve performance significantly! I am very sorry for the inconvenience - but I never expected that amount of traffic on the site, so I was a little bit overwhelmed by that :-) But I hope that the issue is improved now!
xx__yy 6y ago
Is it actually a study on human behavior?
- magnusbaringer 6y ago
  Thank you for your interest and feedback. Yes - in some ways it is. We want to get a far more profound understanding of the influence the different parameters (e.g. size, shape, areola sizes, areola positions etc.) have on the aesthetic perception of the female breast. So in the end we would love to get results like: in case of a areola asymmetry, more people tend to accept a asymmetry than a correction when you therefore have scars. I hope that explanation helps a little bit. Thank you for your time and support.

Rick1 6y ago

Slow loading times aside, looks well made.

magnusbaringer 6y ago
Thank you very much for the kind feedback and your support! I will try my best to improve the loading times.
magnusbaringer 6y ago
Just a quick update: I hope to have improved loading times significantly with some code improvements. Thank you for your support!

DoreenMichele 6y ago

The landing page is safe for work. The survey itself involves looking at bare breasts, so is "NSFW." Breast cancer runs in my family. Two close relatives have had it more than once starting at early ages. My impression is you are barking up the wrong tree. What is "aesthetically pleasing" to random strangers according to some survey is of little importance. If she is in a serious committed relationship, her partner's opinions will be really important to her decision-making process. If she is really young, this will tend to matter a lot more to her than if she is older. Scarring is not just about aesthetics. It's about pain and swelling and limited movement and things like that. That tends to get short shrift by people in the business of selling you surgery for the purpose of improving your appearance. I started the survey but didn't finish it. It's boring and repetitive and I thought images were weird, starting with the detail that there are no arms. Like I'm supposed to care about a woman's breasts and not be bothered by the fact that she has no arms? As a woman who gets tired of some people acting like I am only a sex object and the only parts of me that matter are the parts covered by a bikini and as someone with a serious disability, I find details like that pretty insensitive and disturbing.

Rick1 6y ago
> What is "aesthetically pleasing" to random strangers according to some survey is of little importance. It's extremely important to most people. We go out of our way to look good. Just look at any shopping street. Clothes, makeup, gyms, etc.
- parineum 6y ago
  The goal of not caring what other people think about your physical appearance is noble but naive and I'm not even really certain it's ideal. It's definitely something that people say in situations like this but if you'd ask literally anybody who's had a mastectomy if they could keep their breasts looking exactly the same before surgery as they did before, I guarantee that nearly all of them would want that. I think it's much more important to help people be confident in themselves with their new appearance than it is to tell them they are just the same as they were before. I think it's misguided to try and convince people that they didn't lose something.

deleted 6y ago

[deleted]

julienreszka 6y ago

why is it loading so slowly

conductr 6y ago

I took the survey. I see the value in this. Simply because aesthetics are important (big concern for patient) and maybe you could use data to help them make a big decision in a data driven way on which type of surgery to choose. As with other surveys like this, and perhaps eye exams, I found myself several times thinking "these two look the same", or "I have no obvious preference", or "I like both". I'm bringing it up because I think that's valuable data that should be considered.

magnusbaringer 6y ago
Thank you very much for your time taking part in the survey and your great feedback. That is exactly our goal - to help patients with decision making. Patients often are quite unsure about what is the aesthetically best option for them and want to know what people prefer in general - and the least we should be able to do for patients is give the good and research-backed advice. We know that some picture combinations look very similar - however there are no duplicates in the survey. However of course, sometimes it is quite difficult to make a decision. But we also measure the time of every decision - so in the end we will be able to tell which aspects are quite obvious and therefore quick and easy to decide - and which are not. Thank you for your support!
- conductr 6y ago
  Good to hear you thought of it, I would say that due to load time, the response measure should be suspect. Using myself as an example, I clicked, read some news, came back and clicked, go get a drink, etc. Took me over an hour to finish.
  - magnusbaringer 6y ago
    Really? I am super sorry for that inconvenience - and even more thankful that you took the time to finish despite these enormous loading times. I will try my best to improve that! Thank you so much for that feedback!
    - 6y ago

ampdepolymerase 6y ago

Unrelated but which library did you use for the loading spinner? It is the exact same widget as the one used by the new Medium site.

magnusbaringer 6y ago
Thank you for your comment. I have used this spinner for 5 or 6 years already. It is just a GIF - to be honest I can't remember where I got it from back then.

nacs 6y ago

After I answer a question, it goes back to the "Start the survey" screen every time (browser: Firefox v83)

givehimagun 6y ago
Firefox v82 here and mine worked...except there were long wait times between images.
magnusbaringer 6y ago
Thank you for your interest and taking the time. Did you select a gender and age group? If one of those selections is not selected, you will be taken back to the landing page. Could this maybe cause the problem? Thank you for your support!
- alisonkisk 6y ago
  Yes, but you should change the website to block before the survey starts, instead of just being broken. Also, your data set is likely to be overwhelmed by foods and trolls. Good luck.

roel_v 6y ago

Very cool research. I'm sure there are lots of people on here who would love an in-depth write up of how you construct these images.

magnusbaringer 6y ago
Thank you so much for this kind feedback! To be honest I am completely overwhelmed by the amount of responses and feedback - I never expected that. I will happily put together more in-depth information about how the project came to life and how everything works! I just have to try to keep up with all comments and responses first :-) Thank you for your support!
- roel_v 6y ago
  Oh I'm sure nobody expects you to write anything up tonight :) After getting along a bit further in the survey, I'm also interested in how you're going to approach the analysis of the responses, more specifically, how you're going to separate out the personal preferences of respondents, since I've had a few cases now where the choice was basically "do I find large breasts more attractive than smaller ones" - even if there were some minor other factors at play in the specific images. Anyway, good luck, although I do agree with some other posters that you might get more people to complete the whole thing if you'd show them fewer images; it takes a long time to get through a full round.

adzm 6y ago

Will this data be available publicly? Also are the images tagged with metadata about measurements?

magnusbaringer 6y ago
Thank you for your comment and interest! We will definately publish all data - after all we want to help patients and surgeons so we have to get all the data out to them! At the moment we are just a little bit overwhelmed by the amount of feedback and participants to be honest :-) But of course all data will be published! We have an email subscription box at the end of the survey - we will notify everyone who is interested as soon as we publish the data. What exactly do you mean with metadata and measurements? Do you mean the breast sizes? The breast conditions are rendered from 3D-measured breasts of real patients - so the displayed conditions and breast sizes are completely based on real measurements and the corresponding measures (e.g. cup-size).

brian_c 6y ago

Disappointing that all the images are built on the same shade of white skin. You're leaving out a whole lot of folks who are already underrepresented in a whole lot of research. I think it'd be helpful to vary the skin tones shown, or stick to a medium-tone (enough to be ambiguous) grayscale.

magnusbaringer 6y ago
Thank you very much for your feedback and time! We know that we do not cover aspects like skin tone - and we would love to somehow implement that. The problem is that to get the best statistical results, the "decision-influencing" differences between images ideally have to be reduced to just the exact condition (e.g. different breast size). Every other additional variation (e.g. skin tone) would "blur" the data. As we need 88 picture pairs to cover all required breast conditions anyways, it is practically impossible to take any other aspects into the survey (e.g. skin tone) without completely exploding the number of pictures and blurring the data. So we apologize for that "inconvenience" - but we haven't found a better solution. Thank you very much for your support and feedback!
- shigawire 6y ago
  Maybe that could be a selection criteria at the start? If you add 5 skin tones doesn't that only x5 the number of images?
- waterhouse 6y ago
  I wouldn't even call it white skin, actually. It's not really a flesh color; breaking out the Digital Color Meter, it's slightly warmer than a grey. Then there's the way light reflects off of it, some of it looking rough or dirty in a way skin usually doesn't, with some parts brightly lit as if by one very bright source. (I think glare explains some of it.) The breasts themselves often look brighter, and sometimes cleaner, than everything else; occasionally they do match the surrounding skin, which naively looks a lot better until I realize I have to abstract out the lighting. Even if you can't vary the skin tones, I think that using more uniform lighting would help. And maybe something dumb like spraypainting the main body a mono-color would work, although that might make it more complex to show scars.

Raphmedia 6y ago

I am part of the transgender demographic. Thank you for your work, for us it is life saving. A lot of trans people can only afford one surgery in their life time and so many complain of having received poor results. I hope your dataset improves the results of everyone, everywhere!

magnusbaringer 6y ago
Thank you so much for your support and this kind feedback! We will do our best - and if only one surgery can be improved, we already helped one patient to get a better result than otherwise. Thank you for your time and support!

wolverine876 6y ago

I expect the following is not novel to you, but would you share how you address it with your patients and in this study? In my experience - not based on professional expertise - when people are very concerned about what others will think, in regard to any topic, it is due to a lack of self-worth or self-understanding. They want others to fill that hole, to provide the answer or esteem that they have trouble providing to themselves; they put enormous power in others' opinions. The solution is not to talk about what others think but to find help them find those things within themselves - how do they feel about their choice, their action, their physical being. This study (which I understand might represent only one aspect of your strategy with patients) focuses only on what others think as an answer to the patients' uncertainty. It seems to assume that the worth of the patients' own bodies depends on pleasing others, that the value of this body part is as objects of pleasure for others. And of course we know well that our society sends that message to women, about this body party in particular, very often. And to avoid any misunderstanding, I'm not setting up some argumentative binary concept that people don't care at all how they look. To varying degrees, everyone cares. But I worry far more about the self-esteem and emotional health of the patients than I do about how their breasts look (Edit: And I assume you do too and are acting in good faith). For their breasts, the only person to please is themselves.

wolverine876 6y ago
Mods - I'm almost certain I posted the above as a reply to the original top post: https://news.ycombinator.com/item?id=25169521 https://news.ycombinator.com/item?id=25169521 What happened?
- nickff 6y ago
  Your comment probably got split off because it was not a reply to the OP's comment, it was a general commentary on the topic.
  - wolverine876 6y ago
    Hmmm ... I haven't seen much of that happening on HN. People respond to the top comment all the time. Also, it was a direct question to the person who posted the top comment, not a commentary.

magnusbaringer 6y ago

Dear HN-Community, First of all I want to thank you all very much for all this wonderful support, kind feedback and overall interest in the study. I am completely overwhelmed by the amount of responses and interest. I try my best to keep up with all comments and feedback. It is nearly 23:00 o'clock here in Germany and I had a day full of surgeries - and my schedule for tomorrow is packed as well. So please forgive me if I have to grab a few hours of sleep and may not be able to answer all questions immediately. I will do my best to keep up with everything as good as possible! Just a few additional information in general in response to some frequently asked questions. The goal of this study is to get a more profound understanding of what aspects and factors of the female breast in connection with breast surgeries are being percieved as aesthetically pleasing. Why is this so important? Of course we know that beauty is in the eye of the beholder - and surgery decisions are not based on aesthetics alone. But believe it or not - in the majority of cases patients are overwhelmed by taking decisions regarding the surgery of their own breast. Especially in case of breast cancer, the situation is so difficult and live changing for patients, that it's super difficult to take clear decisions or even just focus on own preferences. Other obvious factors like medical aspects or potential pain aside - for many patients it is extremely important to get profound pre-operative advice on what "generally" is seen as "aesthetically pleasing". E.g. do people like it more if there is a slight asymmetry after breast reconstruction - or is it better to do a correction but therefore have scars. There are many decisions that have to be taken - and for most patients it is very helpful to get good advice. Of course there are patients that know exactly what they want - and what their preferences are. However - as strange is this might sound - for the majority of patients that is not the case. The goal of this study is to get a better understanding of what factors and aspects of the female breast and surgery conditions do have an influence of the aesthetic perception. The survey contains 88 picture pairs - no pair is equal (although some look quite similar). The order of the pictures is being randomized for every participant. The number of 88 pictures is the minimum number that we need to cover every possible "real-life" condition of a breast to get enable a profound statistical analysis. Some pictures might seem similar to you - but your decision allows us to gather a lot of data about why you took that decision and thereby better understand what factors really have an influence. In the end, we hope to find out what aspects do matter more than others - in order to then be able to give patients better advice (e.g. scars are percieved as more aesthetical than an asymmetry if the asymmetry is just one cup size). We know that this study is not perfect - but as far is we know it is by far the most sophisticated study in this area so far. Therefore we hope that we can maybe gather new helpful data. And if only one surgery can be improved, we already helped one patient to get a better result than otherwise. Therefore, thank you all very much for your support and time! I will do my best to reply to every comment and feedback! Thank you, Magnus

loceng 6y ago

May it be worth having another question before survey starts: when was the survey taker last sexually active (to orgasm) to see how/if selection changes?

magnusbaringer 6y ago
Thank you for your support and interest in the project - and of course this thoughtful input. We have had hours of discussions on how many "metadata" we ask for. The two main reasons for the fact that we decided on just gender and age are on the one hand the more data you ask for, the less people will take the time and effort to start the survey (so we wanted to make the "barrier" for participation as minimal as possible). On the other hand, this study has been designed completely in alignment to approvals by the ethics committee of our university and they demanded us to gather as little as possible "personal" data of the participants. I hope that explanation helps a little bit. Thank you for your support!
- loceng 6y ago
  Understandable but I'd argue that it's quite an important attribute - as it's known that post orgasm people's sexual drive/interest is/can be greatly reduced - and therefore what is stimulating will be different. I'd highly recommend having that additional field (that isn't personally identifying data either which is where I assume the concern is) if you run this experiment again - which I hope you do with better load times, things like different torso sizes - as proportion of breasts to torso size has an impact, etc. Still kudos to you for the work.

thaumaturgy 6y ago

FWIW there's a subreddit community dedicated to "ideal" breast shape, which they explain in a pinned post: https://old.reddit.com/r/fortyfivefiftyfive/comments/ark20j/this_should_be_a_sticky/ https://old.reddit.com/r/fortyfivefiftyfive/comments/ark20j/... (NSFW; the community is for porn and the top of the is full of their favorite images). The pinned post cites another study. It looks like you're trying to evaluate the importance of a lot more details than that, and I'd be shocked if you weren't already aware of that study, but there it is just in case.

deleted 6y ago
[deleted]
magnusbaringer 6y ago
Thank you very much for your interest and support! In deed we were already aware of this study. However we want to get a far more profound understanding of the influence different parameters have on the breast. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So results of the study will be something like: in case of an areola size asymmetry, more people tend to accept the asymmetry then a size correction when you therefore have scars. I hope that explanation helps a little bit! Thank you very much again for your support!

wolverine876 6y ago

Magnus - We're not raising simplistic issues about whether beauty is in the eye of the beholder, but addressing how those women are best helped. It's indeed heart-breaking to hear how difficult the situation is. For example, when they are overwhelmed with the decision, terrified about what everyone else will think, then perhaps a mental health professional would be the better option to help them through it then someone with authority (the surgeon) reinforcing to them, with research, that everyone else's opinions are essential. Edit: I'm not sure that's what's going on, but I think it's a reasonable concern about the survey and how it will be used. I'm posting this because the two questions below about this issue didn't receive responses and the way the issue is addressed above seems to possibly trivialize the questions, but that could be unintended or a language issue. Sorry if I'm misunderstanding you.

nickff 6y ago
You're asserting that people who have suffered cancer and a very invasive (likely traumatic) operation probably have mental health issues as well? I'm all for people consulting counselors and psychologists, but many people want to get back to normal, and part of that is to look the same as they did before, and avoid others asking them very personal questions or making hurtful comments. The doctors performing reconstructive surgeries are not taking advantage of vulnerable individuals, they are helping support people's recoveries.
- wolverine876 6y ago
  > I'm all for people consulting counselors and psychologists, but many people want to get back to normal, and part of that is to look the same as they did before, and avoid others asking them very personal questions or making hurtful comments. The doctors performing reconstructive surgery are not taking advantage of vulnerable individuals, they are helping support people's recoveries. I'm not sure I understand ... ? First, I certainly didn't say that the doctors are taking advantage of anyone and certainly don't think so! I don't even know what ulterior motive the doctors would have. Please don't attribute things to me. The job of mental health professionals is to help the patient achieve whatever their goal is, whether that's 'getting back to normal' or to help with a difficult decision or situation. Who are you saying would be "asking very personal questions and making hurtful comments"? Mental health professionals? Mental health treatment is not an inquisition; there's no judgment made. Just like the surgeon, their job is to help the patient. ---- The doctors have asked us to take a survey. It's reasonable to raise legitimate concerns about that survey; we're not and shouldn't be thoughtless and unskeptical.

boobybomb 6y ago

Technology gone berserk.

dang 6y ago
Creating accounts to break HN's guidelines with will eventually get your main account banned as well, so please don't do that. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

haram_masala 6y ago

This reminds me of a optometrist exam. And, gives me an idea for an improved version of one.

darig 6y ago

This study seems biased to always select reconstruction. Why isn't there an option showing no reconstruction, or an option to say neither reconstruction is aesthetically pleasing?

magnusbaringer 6y ago
Thank you very much for your interest in the study and your feedback! I do understand where your concern comes from. However, in the statistical analysis of the data we do not look at the "complete" breast images. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So the result of the study will not be "reconstruction is preferred". Instead we want to get a far more profound understanding of the influence the different parameters have on the breast. So results of the study will be something like: in case of an areola size asymmetry, more people tend to accept the asymmetry then a size correction when you therefore have scars. I hope that explanation helps a little bit! Thank you very much again for your support!
- darig 6y ago
  I have a degree in mathematics, so you don't need to explain statistical analysis to me. That would be as ludicrous as me pointing out to a medical doctor what a control group is... but here we are.

magnusbaringer 6y ago

Dear HN-Community, Just a quick update after a very short night :-) Thank you so much for all the support, wonderful feedback and of course the time you take for this project! If just improved the code - so I hope that loading times are reduced significantly now! I apologize to all who have taken the survey so far despite the long loading times - I am very sorry for the inconvenience! Thank you for your effort in supporting this study! I hope the loading time issue is significantly improved now! Greetings from Germany, Magnus

dotancohen 6y ago

> It would be awesome if you would sacrifice > 5 minutes of your time to support this project. Five minutes of looking at breasts for science? I'm willing to make that sacrifice.

magnusbaringer 6y ago
Thank you very much for your time and support! It really means a lot!
- dotancohen 6y ago
  After taking the survey, I must express two things that I've realized during the survey. For one, my personal preference may not be the chest that is "more aesthetically pleasing" even though that is what the survey explicitly asks for. There are considerations other than aesthetics that should be considered. In my opinion, instead of the survey showing two cases (one perfect, one slightly afflicted), the survey should show just the afflicted chest and ask "is this aesthetically pleasing or not". Of course the perfect chest is more pleasing, but that does not mean that there was any problem requiring intervention on the other chest. I've noticed that asymmetry with regards to breast size really are not a problem (for me), even in extreme cases. I've noticed this asymmetry in many women who have not had breast cancer or other afflictions. However, nipple asymmetry does stand out, especially vertical asymmetry. Two nipples at different heights does look terrible, and if aesthetics are an issue then I could understand performing surgery for those cases.
  - magnusbaringer 6y ago
    Thank you very much for your time and support! I do understand your concern - however the data collection works a little bit different "under the surface" as it seems. In the statistical analysis of the data we do not look at the "complete" breast images. The study is designed in a way, that the most important parameters around breast (reconstruction) surgery (e.g. breast size, breast shape, areola size, areola position, scars etc.) are being combined in 88 images in a way that in the end allows us to extract the data "broken down" to the different parameters. So the result of the study will not be "people like image X more than image Y". Instead we want to get a far more profound understanding of the influence the different parameters have on the perception of the breast. As we also measure the decision time, results of the study will be something like: "most people (or maybe just men - that's what we want to find out) tend to accept breast size asymmetry more then areola asymmetry. The decision happens much faster on areola asymmetries - so that seems to be more obvious and therefore has to be taken more care of during the surgery." Nobody has every done a profound analysis of these individual parameters alone - so that is where we see huge potential for a better understanding. I hope that explanation helps a little bit! Thank you very much again for your support!

magnusbaringer 6y ago

Dear HN-Community, Another quick update. We launched this study not even 1 week ago - with our 4 week goal being 100 participants and our half year goal being 1000 participants. After sharing the study to friends and family, we were already able to reach 1.300 participants within the first 4 days - which was already mindblowing for us and exceeded all our expectations. With 1000 paticipants the data would probably already have been better then most research that has ever been done in this field. Thanks to the support of this unbelievably kind and helpful community we have now reached more than 6100 participants, collected more than 160.000 votes and nearly 800.000 datapoints in our database. The amount of extremely valuable and helpful data is just beyond believe for us - and I cannot thank you all enough for all your support, effort and positive feedback! We are now on the edge of creating one of the most if not the most profound studies in the field of breast surgery ever - and the amount of extremely helpful knowledge we can get from the data is just overwhelming. Thank you HN for this wonderful opportunity, all your support and all your fantastic feedback and kind help!

jamesiscool 6y ago
This is awesome, but are you worried that you know what HN readers think about breast reconstruction aesthetics and that that may not exactly match the general population. Guess you can compare it to the first 1,300 responses?

magnusbaringer 6y ago

Dear HN-Community, I know this might be a little different post - but we hope it might be appropriate nevertheless. I am a physician in reconstructive and plastic surgery with a passion for technology. A big part of my job is breast reconstruction (e.g. after breast cancer, malformations etc.). Usually, those surgeries are extremely stressful (and in case of cancer lifechanging) for patients - which makes decision taking very difficult for them in most cases. It is a fundamental part for surgeons to support and accompany patients on their way. Many important decisions have to be taken - by the patient as well as by surgeons. E.g. in case of an asymmetry after breast cancer patients have to decide whether they prefer to live with an asymmetry or an alignment, which, however, leads to scars. As simple as this decision may sound for you - for most patients it is not. Unfortunately, the is no realiable data and research on a larger scale so far, that allows surgeons to better understand what patients (and society in general) accepts as an "aesthetically pleasing" outcome. Therefore I built a web based software, that is able to create relatively realistic models of various breast conditions - e.g. different breast sizes, asymmetries, scares and so on. I then built this software into a survey, that mixes different conditions in a pseudo-random way, that allows us to gather a vast amount of realiable data on a scale that has never been seen in this field of medicine before - which ultimately would significantly improve advice and also surgery for patients. It would be awesome if you would sacrifice 5 minutes of your time to support this project. I am looking forward to answering any questions. Thank you for your time and support.

danielh 6y ago
I followed the link before I read your comment. On mobile, I did not notice that there is any scarring or thought it was just rendering artifacts. I would expect your results to be skewed toward the more symmetrical images. Also, is there any reason why the survey takes five minutes? Why not limit it to 10 images, with the option to keep going? I really like the idea, I hope this feedback is valuable.
- magnusbaringer 6y ago
  Thank you very much for your time and feedback! The scars are indeed not too prominent. In fact we had ours of discussions about the intensity of the scars - in the end we decided to go for a scar intensity that equals the average scar after about 2 years (so they wouldn't be too obvious in reality either). The survey has 88 picture pairs that are mixed randomly. These 88 pairs are the absolute minimum to cover all relevant breast conditions in a way that allows us to get good statistical data. We calculated the average decision time per picture pair with 3 seconds - hence the 5 minutes. However the survey is structured in a way that if a participant only clicks 10 pictures, we can still use the data from those 10 clicks. So every click counts - and if someone is kind enough to click all 88 pictures, we get a full set of data. Thank you very much for your interest and support!

gus_massa 6y ago

Does this need a NSFW tag, for people that live in a silly country? Are the position of the images randomized, or you show always the non-intervention version on the same side? It's a little too long. I'll try to complete it later. The images take too long to load, and you can see how they are constructed. It is slightly weird.

magnusbaringer 6y ago
Thank you for your reply and your feedback. I'm not sure about the NSFW tag - however if you select age under 18 you cannot start the survey, so I hope it is ok without the NSFW tag. The order of the images is completely randomized - so the survey is never the same for two participants. The images however follow a complex algorithm - no image pair shows up twice. The number of images - although admittedly quite high - is the absolute minimum amount to simulate every important condition/decision-combination relevant for surgery. The load time was optimized - however depending on your location and server load it might of course be a little to long (I try to further improve that). Thank you very much for your support!
- gus_massa 6y ago
  How many images are there in total? It looks like the images are generated from smaller parts that are downloaded separately. Perhaps you can download all the parts in hidden images and combine them on demand. Also, perhaps you can render the images in a hidden canvas while the user is selecting the previous pair of images, so when the user makes a click the change has no pause.