The Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 33# Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
Aesthetic Plast Surg. 2021 Oct;45(5):2135-2145. doi: 10.1007/s00266-021-02241-3. Epub 2021 Mar 23.
Intraoperative symmetrical assessment plays a decisive role in the aesthetic results of reduction mammaplasty, but it depends mostly on the surgeons' experience that may be biased by individual subjective factors. This study was intended to propose an objective method based on a hand-held three-dimensional (3D) scanner to assist intraoperative symmetrical assessment, aiming to achieve better aesthetic results in reduction mammaplasty.
Sixty patients were enrolled in the study from April 2018 to January 2020. Intraoperative 3D scanning was routinely performed on 29 patients (study group) to assist symmetrical adjustments during breast shaping. 3D surface scanning data of both groups were obtained at 3 months postoperatively to objectively assess breast symmetry. Postoperative symmetry scores in five aspects, including nipple-areolar complex position, inframammary-fold height, breast size, shape, and footprint, were rated by six independent observers based on anonymized photographs to subjectively evaluate pre- and postoperative breast symmetry of the two groups.
The bilateral breast volume difference of the study group was significantly smaller than the control group (39.1 vs. 113.3 cm, p = 0.001), as well as the difference in nipple to inframammary-fold distance (2.79 vs. 7.43 mm, p = 0.01). The observer-reported results showed that breast reduction significantly improved postoperative symmetry in all five aspects compared with preoperative symmetry in the study group (P<0.001). Furthermore, postoperative symmetrical ratings of all five aspects in the study group were statistically better than the control group (P<0.05).
Intraoperative 3D scanning provided a reliable method to assist symmetry adjustments and ensure better postoperative breast symmetry in reduction mammaplasty.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
术中对称评估对乳房缩小成形术的美学效果起着决定性作用，但它主要依赖于外科医生的经验，而这些经验可能会受到个体主观因素的影响。本研究旨在提出一种基于手持式三维（3D）扫描仪的客观方法，以协助术中对称评估，旨在实现乳房缩小成形术中更好的美学效果。
本研究纳入了 2018 年 4 月至 2020 年 1 月的 60 例患者。对 29 例患者（研究组）常规进行术中 3D 扫描，以协助乳房塑形过程中的对称调整。两组患者均在术后 3 个月获得 3D 表面扫描数据，以客观评估乳房对称性。6 名独立观察者根据匿名照片对术前和术后乳房对称性进行主观评估，对包括乳头乳晕复合体位置、乳房下皱襞高度、乳房大小、形状和乳沟在内的 5 个方面进行对称性评分。
研究组双侧乳房体积差异明显小于对照组（39.1 比 113.3cm，p=0.001），乳头至乳房下皱襞距离差异也有统计学意义（2.79 比 7.43mm，p=0.01）。观察者报告的结果显示，与术前相比，研究组所有 5 个方面的乳房缩小术后对称性均显著改善（P<0.001）。此外，研究组所有 5 个方面的术后对称评分均明显优于对照组（P<0.05）。
术中 3D 扫描为辅助对称性调整提供了一种可靠的方法，确保了乳房缩小成形术更好的术后乳房对称性。
证据等级 IV：本杂志要求作者为每篇文章指定一个证据等级。有关这些循证医学等级的详细说明，请参考目录或在线作者指南 www.springer.com/00266 。
