A Novel Method of Outcome Assessment in Breast Reconstruction Surgery: Comparison of Autologous and Alloplastic Techniques Using Three-Dimensional Surface Imaging

Hartmann, Robin; Weiherer, Maximilian; Schiltz, Daniel; Seitz, Stephan; Lotter, Luisa; Anker, Alexandra; Palm, Christoph; Prantl, Lukas; Brébant, Vanessa

doi:10.1007/s00266-020-01749-4

Cited by 15 publications

(17 citation statements)

References 26 publications

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“…Every patient underwent 3D surface imaging. For every patient, 14 anthropometric measurements were obtained manually using a tape measure, and 14 measurements were obtained automatically using the 3D data by our software, which has been described elsewhere [13].…”

Section: Methodsmentioning

confidence: 99%

“…The previous protocol [13] required 360° body scans to determine the vertebra prominens as a landmark. In the improved version of our software, the sagittal plane is determined using just 180° scans.…”

Section: Landmarksmentioning

confidence: 99%

“…The shortest UBP-N distance represents measurement (3). The described measurements were used to calculate the Symmetry Index (SI) according to our previously described protocol [13]. It combines measurements (1)-( 7) into one analytical 6) Xiphoid (Xi), (7) Lower Breast Pole (LBP), ( 8) Nipple (N), ( 9) Upper Breast Pole (UBP) value.…”

Section: Anthropometric Measurementsmentioning

confidence: 99%

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New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry

Hartmann

Weiherer

Schiltz

et al. 2020

Arch Gynecol Obstet

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Purpose In this trial, we used a previously developed prototype software to assess aesthetic results after reconstructive surgery for congenital breast asymmetry using automated anthropometry. To prove the consensus between the manual and automatic digital measurements, we evaluated the software by comparing the manual and automatic measurements of 46 breasts. Methods Twenty-three patients who underwent reconstructive surgery for congenital breast asymmetry at our institution were examined and underwent 3D surface imaging. Per patient, 14 manual and 14 computer-based anthropometric measurements were obtained according to a standardized protocol. Manual and automatic measurements, as well as the previously proposed Symmetry Index (SI), were compared. Results The Wilcoxon signed-rank test revealed no significant differences in six of the seven measurements between the automatic and manual assessments. The SI showed robust agreement between the automatic and manual methods. Conclusion The present trial validates our method for digital anthropometry. Despite the discrepancy in one measurement, all remaining measurements, including the SI, showed high agreement between the manual and automatic methods. The proposed data bring us one step closer to the long-term goal of establishing robust instruments to evaluate the results of breast surgery. Level of evidence: IV.

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Section: Methodsmentioning

confidence: 99%

Section: Landmarksmentioning

confidence: 99%

Section: Anthropometric Measurementsmentioning

confidence: 99%

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New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry

Hartmann

Weiherer

Schiltz

et al. 2020

Arch Gynecol Obstet

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“…Breast symmetry was quantified using the Symmetry Index (SI). According to [7], the SI allows a symmetry calculation between 0 (worst) and 1 (best) by means of seven anthropomorphic measurements, shown in Figure 1. Post-operative breast volume was calculated using the Breast-V formula as proposed by Longo et al [8] for ptotic and extended by Huang et al [9] for non-ptotic breasts.…”

Section: Implant Augmentationmentioning

confidence: 99%

Implants versus Lipograft – Analysis of Long-Term Results after Congenital Breast Asymmetry Procedure

Brébant¹,

Weiherer²,

Noisser³

et al. 2021

Preprint

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Congenital breast asymmetry represents a particular challenge to the classical techniques of plastic surgery due to a young group of patients. This study compares traditional breast augmentation using silicone implants to the more innovative lipograft technique regarding long-term results. To achieve this, we not only captured subjective parameters like satisfaction with outcome and symmetry, but also objective parameters such as breast volume and anthropometric measurements. Objective examination was performed manually and by using the Vectra® H2 photogrammetry scanning system. Patients who underwent implant augmentation and lipograft both showed no significant differences in patient´s satisfaction with surgical outcome (p = 0.55) and symmetry (p = 0.69). Furthermore, a breast symmetry of 93 % in both groups was reported. Likewise, no statistically significant volume difference between left and right breast was observed in both groups (p<0.41). However, on average, lipograft patients needed 1.3 procedures more until the desired result was achieved. In contrast, patients treated with implant-based breast augmentation usually need several implant changes during their life. In conclusion, both methods should be considered for patients with congenital breast asymmetry.

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“…(3D) surface body measurement have offered new possibilities to numerically assess the female breast [1,2,[6][7][8][9][10][11][12][13][14][15][16]. These technologies are characterized by significantly faster data acquisition compared with linear and circumference measurements, water displacement and other conventional methods [11,14].…”

Section: Introductionmentioning

confidence: 99%

“Topographic Shift”: a new digital approach to evaluating topographic changes of the female breast

Lotter

Brébant

Eigenberger

et al. 2020

Arch Gynecol Obstet

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Purpose To assess precise topographic changes of the breast, objective documentation and evaluation of pre- and postoperative results are crucial. New technologies for mapping the body using digital, three-dimensional surface measurements have offered novel ways to numerically assess the female breast. Due to the lack of clear demarcation points of the breast contour, the selection of landmarks on the breast is highly dependent on the examiner, and, therefore, is prone to error when conducting before-after comparisons of the same breast. This study describes an alternative to volumetric measurements, focusing on topographic changes of the female breast, based on three-dimensional scans. Method The study was designed as an interventional prospective study of 10 female volunteers who had planned on having aesthetic breast augmentation with anatomical, textured implants. Three dimensional scans of the breasts were performed intraoperatively, first without and then with breast implants. The topographic change was determined as the mean distance between two three-dimensional layers before and after augmentation. This mean distance is defined as the Topographic Shift. Results The mean implant volume was 283 cc (SD = 68.6 cc, range = 210–395 cc). The mean Topographic Shift was 7.4 mm (SD = 1.9 mm, range = 4.8–10.7 mm). The mean Topographic Shifts per quadrant were: I: 8.0 mm (SD = 3.3 mm); II: 9.2 mm (SD = 3.1 mm); III: 6.9 mm (SD = 3.5 mm); IV: 1.9 mm (SD = 4.3 mm). Conclusion The Topographic Shift, describing the mean distance between two three-dimensional layers (for example before and after a volume changing therapy), is a new approach that can be used for assessing topographic changes of a body area. It was found that anatomical, textured breast implants cause a topographic change, particularly on the upper breast, in quadrant II, the décolleté.

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A Novel Method of Outcome Assessment in Breast Reconstruction Surgery: Comparison of Autologous and Alloplastic Techniques Using Three-Dimensional Surface Imaging

Cited by 15 publications

References 26 publications

New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry

New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry

Implants versus Lipograft – Analysis of Long-Term Results after Congenital Breast Asymmetry Procedure

“Topographic Shift”: a new digital approach to evaluating topographic changes of the female breast

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