Predictability of anthropomorphic measurements in implant selection for breast reconstruction: a retrospective cohort study

Abstract

Background Preoperative implant planning for breast reconstruction is often at risk of being changed perioperatively. This study examined which factors are associated with a change of implant selection. Methods Women who had unilateral two-stage breast reconstruction between 2002 and 2007 were studied. Inclusion criteria were photographic evidence of preoperative skin markings indicating breast dimensions and a selected implant model. Multivariable logistic regression was used to identify variables associated with a changed selection. Results Among the 496 women studied, 308 preoperative implant choices (62.1%) were changed during surgery. A change in plan was significantly associated with symmetrization surgery involving contralateral reduction mammaplasty (OR = 1.92; 95% CI, 1.12 to 3.29) and contralateral mastopexy (OR = 2.26; 95% CI, 1.29 to 3.96), but not with BMI. The required implant width changed more than 0.5 cm in 70 cases (14.1%) while height changed more than 0.5 cm in 215 cases (43.2%). The likelihood of a change was high for large preoperative widths (OR = 9.66 for 15.5 cm) and small preoperative heights (OR = 2.97 for 10.5 cm). At a mean follow-up of 16.6 months, patient satisfaction was good or average in 92.1% of cases and 5.9% of implants had been replaced with another model, indicating that the perioperative implant selection was usually appropriate. Conclusions This study documents the frequency with which implant choices, despite accurate preoperative planning, are changed perioperatively as a result of relatively small differences in anthropomorphic measurements. Perioperative recalculation of breast dimensions may have an advantage in terms of patient reoperation rates. Changes in width were less frequent than changes in height and projection. Contralateral surgery, large width, and small height were the most influential factors. Level of Evidence: Level IV, risk / prognostic study.

Brassiere Cup Size Agreement between Patients and Plastic Surgeons: Do Surgeons and Patients Speak the Same Size Language?

“…All anthropometric volume measures of the breast are complex to perform and always represent estimates 29–34 and volume measures using 3D scans likewise. When used appropriately for 3D simulation, volume estimates can, however, be accurate.…”

“…28 The plastic surgeons felt almost as comfortable evaluating 3D scans as with performing clinical examinations. 7 All anthropometric volume measures of the breast are complex to perform and always represent estimates [29][30][31][32][33][34] and volume measures using 3D scans likewise. When used appropriately for 3D simulation, volume estimates can, however, be accurate.…”

An Aesthetic Factor Priority List of the Female Breast in Scandinavian Subjects

“…In this study, NAC to inferior mammary fold and breast projection were found to be significantly associated with breast attractiveness, while base diameter was not. 20 The base diameter is relatively easy to measure and has been shown by Riggio et al 21 to change less often from preoperative planning to intraoperative decision in implant breast reconstruction. On the other hand, base diameter is used frequently in clinical practice to assist in choice of implant.…”

Braxon®-assisted prepectoral breast reconstruction: A decade later

“…Preoperative planning continues with accurate measurements that provide the landmarks for drawings and help detect any asymmetries. Attention is focused on the following: the distance from the sternal notch to the nipple, the position of the IMF, breast width, distance from the nipple to the IMF, and distance from the nipple to the midline ( 83 ).…”