Background – Recent studies suggest that three-dimensional (3D) imaging of the breast may be clinically useful for plastic surgeons. This technology offers exciting new opportunities to not only help guide surgery, but also provides a unique tool for post-operative analysis. The following study investigates the novel use of 3D imaging to assess changes in surface anatomy, volume, and tissue distribution following reduction mammaplasty (RM).

Methods – 3D laser scans of the breast were obtained from patients undergoing RM during pre- and post-operative office visits. Breast models were constructed volume measurements were obtained for each breast, as well as the relative volume of tissue in the upper and lower poles. In order to further define the areas in which significant changes in tissue distribution occurred, topographical color maps were generated by comparing the pre- and post-operative surface images. Breast projection was examined with sagital sections taken through the nipple as well as identifying the maximal point of projection.

Results – 3D scans were obtained in 28 patients that underwent RM. Total pre-operative and post-operative breast volume averaged 1037 ± 27 cm3 and 656 ± 210 cm3, respectively. The percent of tissue above the IMF had increased following RM (24.5% versus 55.1% preoperatively; p<0.001). Color maps and sagital sections highlighted the regions of tissue redistribution, with the majority of spatial changes located in the central region of the upper poles. RM significantly altered the point of maximal breast projection (8.7 ± 2.8 cm below a fixed axillary plane vs. 14.6 ± 2.7 cm preoperatively; p<0.05).

Conclusion – 3D imaging offers a unique approach to assessing volumetric distribution in breast surgery, which was previously unattainable to plastic surgeons. 3D photography now provide a potential means to compare surgical outcomes with each mammaplasty technique as well as follow the changes that occur over time (i.e. bottoming out).