Tepper Oren M, Choi Mihye, Small Kevin, Unger Jacob, Davidson Edward, Rudolph Lauren, Pritchard Ashley, Karp Nolan S
New York, N.Y. From the Institute of Reconstructive Plastic Surgery, New York University Medical Center.
Plast Reconstr Surg. 2008 Jun;121(6):1875-1885. doi: 10.1097/PRS.0b013e31817151db.
Three-dimensional photography of the breast offers new opportunities to advance the fields of aesthetic and reconstructive breast surgery. The following study investigates the use of three-dimensional imaging to assess changes in breast surface anatomy, volume, tissue distribution, and projection following medial pedicle reduction mammaplasty.
Preoperative and postoperative three-dimensional scans were obtained from patients undergoing short-scar medial pedicle breast reduction. Three-dimensional models were analyzed by topographical color maps, changes in the lowest point of the breast, surface measurements, and the point of maximal projection. Total breast volume and percentage volumetric tissue distribution in the upper and lower poles were also determined.
Thirty patients underwent reduction mammaplasty (mean postoperative scan, 80 +/- 5 days). Color maps highlighted the majority of spatial changes in the central, upper poles. Reduction mammaplasty resulted in a significant decrease in the anteroposterior projection of the breast (6.3 +/- 0.2 postoperatively compared with 8.1 +/- 0.2 cm preoperatively; p < 0.01). The point of maximal breast projection was elevated in the cranial-caudal direction (4.8 +/- 0.4 cm; p < 0.01), with a corresponding elevation in the lowest point of the breast (4.8 +/- 0.5 cm; p < 0.01). Volumetric three-dimensional measurements identified a significant change in percentage tissue distribution after reduction mammaplasty (45 +/- 2 percent above the inframammary fold preoperatively versus 76 +/- 2 percent postoperatively; p < 0.01).
This study is the first to demonstrate the technical feasibility and clinical utility of three-dimensional geometric data in medial pedicle breast reduction surgery. This novel approach suggests new opportunities to define long-term operative changes following various breast procedures.
乳房三维摄影为推进乳房美容手术和乳房重建手术领域提供了新机遇。以下研究探讨了利用三维成像评估内侧蒂乳房缩小成形术后乳房表面解剖结构、体积、组织分布及突出度的变化。
对接受短瘢痕内侧蒂乳房缩小术的患者进行术前和术后三维扫描。通过地形彩色图、乳房最低点的变化、表面测量以及最大突出点对三维模型进行分析。还测定了乳房总体积以及上下极的体积百分比组织分布。
30例患者接受了乳房缩小成形术（术后平均扫描时间为80±5天）。彩色图突出显示了中上极的大部分空间变化。乳房缩小成形术导致乳房前后突出度显著降低（术后为6.3±0.2厘米，术前为8.1±0.2厘米；p<0.01）。乳房最大突出点在头足方向升高（4.8±0.4厘米；p<0.01），乳房最低点相应升高（4.8±0.5厘米；p<0.01）。三维体积测量显示乳房缩小成形术后组织分布百分比有显著变化（术前乳房下皱襞上方为45±2%，术后为76±2%；p<0.01）。
本研究首次证明了三维几何数据在内侧蒂乳房缩小手术中的技术可行性和临床实用性。这种新方法为确定各种乳房手术后的长期手术变化提供了新机遇。
