Initial Assessment of VECTRA Three-Dimensional Imaging to Accurately Simulate Breast Volume Changes in Transfeminine Patients: A Mannequin Study

Abstract

Background Methods that aim to accurately measure and predict breast development can be utilized in gender-affirming treatment planning, patient education, and research. Objectives The authors sought to evaluate whether three-dimensional (3D) stereophotogrammetry accurately measures transfeminine breast volume changes on a masculine frame when simulating anticipated changes in soft tissue after gender-affirming surgical therapy. Then, we describe the innovative application of this imaging modality in a transgender patient to illustrate the potential role of 3D imaging in gender-affirming surgical care. Methods A 3D VECTRA scanner (Canfield, Fairfield, NJ) was used to measure anthropometric breast measurements. Postoperative changes in breast volume were simulated on a cardiopulmonary resuscitation (CPR) mannequin using 450cc MENTOR breast implants (Mentor Worldwide LLC, Irvine, CA). To demonstrate the ability of the VECTRA to accurately simulate transfeminizing augmentation in practice, we describe its use in a 30-year-old transgender female with a 2-year history of gender-affirming hormone therapy, presenting for gender-affirming surgical care. Results In the mannequin, mean breast volumes were 382 cc on the right (range 375–388 cc), and 360 cc on the left (range 351–366 cc). The average calculated difference in volume between the two sides was 22 cc (range 17–31 cc). There were no instances where the left side was calculated to be larger than the right or where the calculated size was smaller than the actual implant size. Conclusions The VECTRA 3D camera is a reliable and reproducible tool for preoperative assessment, surgical planning, and simulating breast volume changes after gender-affirming surgery.

Evaluation of Intraoperative Volumetric Assessment of Breast Volume Using 3D Handheld Stereo Photogrammetric Device

“…Not only does it provide a valuable tool for preoperative planning and postoperative assessment, but its potential for intraoperative use could revolutionize the way breast volume and symmetry adjustments are carried out during surgery. By offering a more objective and accurate means of measuring breast volume and symmetry in real-time, the VECTRA H2 3D imaging system has the potential to enhance surgical outcomes and optimize the esthetic results [ 2 , 34 , 37 ].…”

“…Additionally, the integration of 3D imaging technology into breast surgery practices has the added advantage of facilitating better communication between plastic surgeons and their patients [ 2 , 34 ]. With the ability to visualize and demonstrate potential outcomes in a three-dimensional format, patients can gain a clearer understanding of the proposed surgical changes, enabling them to make more informed decisions about their procedures [ 2 , 34 , 36 , 37 ]. This enhanced communication can lead to increased patient satisfaction and confidence in the surgical process.…”

“…To the best of our knowledge, this is the first study to establish an intraoperative 3D volumetric analysis using a validated system [ 2 , 34 , 37 , 46 ]. In addition, this study comprised the largest sample size of all intraoperative 3D volumetric studies in breast surgery.…”

“…This is a convenient and inexpensive method for calculating breast volume, and it has been shown to have an average accuracy of about a 2.2% underestimation of the true breast volume (range −2.17 to −2.28%) [ 34 ]. The VECTRA three-dimensional surface imaging of the breasts for measuring pre- and postoperatively breast volume and shape symmetry has been validated in several studies [ 2 , 34 , 36 , 37 ]. Clinicians and researchers suggest that measurements using the VECTRA technology three-dimensional surface imaging system have the potential to assist in preoperative planning and also as a measure of esthetic outcome [ 2 , 34 , 37 ].…”

“…The VECTRA three-dimensional surface imaging of the breasts for measuring pre- and postoperatively breast volume and shape symmetry has been validated in several studies [ 2 , 34 , 36 , 37 ]. Clinicians and researchers suggest that measurements using the VECTRA technology three-dimensional surface imaging system have the potential to assist in preoperative planning and also as a measure of esthetic outcome [ 2 , 34 , 37 ].…”