Use of Three-Dimensional Imaging to Assess the Effectiveness of Volume as a Critical Variable in Breast Implant Selection

Abstract Background Traditional methods of breast implant size selection provide limited ability to demonstrate postoperative outcomes. Three-dimensional imaging provides an opportunity for improved patient evaluation, surgical planning, and evaluation of postoperative breast appearance. Objectives We hypothesized that preoperative 3D imaging for patients undergoing breast augmentation would improve patient satisfaction and understanding of expected surgical outcomes. Methods A retrospective review of patients undergoing breast augmentation by a single surgeon over a 3.5-year period was performed. Patients presenting after the VECTRA was purchased had preoperative 3D imaging, while patients presenting before this did not. Eligible patients received a BREAST-Q questionnaire designed for postoperative evaluation of breast augmentation. They also received a second survey that evaluated expected versus actual breast outcomes. Results 120 surveys were mailed and 61 patients (50.8%) returned the survey. The 3D imaged group had improved BREAST-Q scores regarding satisfaction with outcome, surgeon, and physical well-being compared to the group that did not. The imaged group also had higher size, shape, and overall breast correlation scores, confidence in implant size selection scores, and communication with surgeon scores. The differences between the two groups were not statistically significant. Conclusions Three-dimensional imaging is a valuable tool in breast surgery. Although our study showed improvement in patient satisfaction and predicted outcome scores in the 3D imaged group, our results were not statistically significant. With the majority of patients reporting they would choose 3D imaging, it appears to instill confidence in patients regarding both surgeon and implant selection.

Download Full-text

Breast Augmentation

10.2310/ps.10086 ◽

2019 ◽

Author(s):

Eric J. Culbertson ◽

William P. Adams Jr

Keyword(s):

Breast Augmentation ◽

Breast Implant ◽

Capsular Contracture ◽

Three Dimensional ◽

Surgical Techniques ◽

Postoperative Recovery ◽

Silicone Implants ◽

Aesthetic Result ◽

Incision Location ◽

Implant Selection

Breast augmentation is a complicated process that goes far beyond placing an implant in a pocket. The implants and techniques of breast augmentation have undergone significant evolution over the past 50 years, and this is now one of the most commonly performed cosmetic procedures worldwide. Advancements in shell barrier technology and silicone form stability have improved implant functional characteristics and mechanical properties. Tissue-based planning uses measurable patient characteristics to match an implant to the patient’s tissue for greater control of the aesthetic result while minimizing complications. The realization of three-dimensional modeling systems allows a more sophisticated approach to implant selection and establishment of patient expectations. Specific surgical techniques, including pocket plane and incision location, ensure ideal implant placement. Optimal patient outcomes are achieved by integrating patient education, implant selection with tissue-based planning, refined surgical technique, and detailed postoperative recovery. This review contains 12 figures, 6 tables, 1 video, and 74 references. Key Words: breast augmentation, breast implants, breast implant-associated anaplastic large cell lymphoma, dual plane, capsular contracture, saline implants, silicone implants, tissue-based planning, three-dimensional imaging

Download Full-text