3D Analysis of Breast Augmentation Patients Defines Operative Changes and their Relationship to Implant Dimensions
Oren M. Tepper, MD, Jacob G. Unger, BA, Kevin H. Small, BA, Daniel L. Feldman, BA, Mihye Choi, MD, Nolan S. Karp, MD.
NYU Medical Center, New York, NY, USA.
Background: Breast augmentation is one of the most common plastic surgery procedures performed in the United States today, yet evaluation of post-operative results lacks true objective measurements. The following study reports the application of three-dimensional (3D) photography to determine the quantitative changes that occur in breast morphology following breast augmentation.
Methods: Patients undergoing augmentation mammaplasty with a periareolar incision underwent pre- and post-operative 3D photographs. 3D models were constructed and the following parameters were assessed: maximum anterior-posterior projection from the chest wall, angle of breast projection, total breast volume, and volumetric tissue distribution in the superior and inferior poles.
Results: A completed series of 3D images were obtained from 14 augmentation patients, or 28 breasts (average post-operative day 143). Saline and silicone implants were used equally (n=14 for each). The internal angle of the breast projection was found to increase by 13.6o (p<0.001), as did the sternal notch to nipple distance (11 mm, p=0.018). Total volume of the breast changed according to implant size (volume 1.9% difference p=0.83), but no significant change in the volumetric distribution within the upper and lower poles were noted between pre- and post-operative scans (p=0.81). Anterior-posterior projection was 20.9% less than the expected anterior-posterior projection of the implant (72.7mm to 58.7mm, respectively p<0.001).
Conclusions: This study documents objective changes in breast morphology following augmentation mammaplasty. 3D imaging quantified the increase in the internal angle of the breast projection, the sternal notch to nipple distance, and in total breast volume following breast augmentation. 3D photography further highlighted that breast augmentation results in less than expected anterior-posterior projection, possibly due to tissue attenuation occurring anterior to the implant. 3D photography therefore offers a powerful new tool to correlate ex-vivo and in-vivo implant dimensions.