Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.
Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Ziemssenstraße 5, Munich 80336, Germany.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3094-3100. doi: 10.1016/j.bjps.2022.06.008. Epub 2022 Jun 17.
Breast volume estimation and implant size are crucial factors to achieve a symmetrical result in esthetic and reconstructive breast surgery. Although three-dimensional surface imaging (3DSI) has allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has been limited regarding intraoperative decision-making.
To validate the intraoperative use of a portable hand-held 3D surface imaging device as an objective tool to assess volumetric changes during breast augmentation surgery.
Patients receiving bilateral, submuscular breast augmentation were enrolled for this study. Intraoperative 3DSI was conducted using the Sense 3D scanner, allowing for digitalization of the operating field. Intraoperatively gauged volume changes caused by known implant volumes were compared with digital measurements calculated from 3D surface images of the operating field. Digital intraoperative breast volumes were compared to the pre- and postoperative Vectra XT reference system.
Eighty individual breasts of 40 patients were successfully 3D imaged before incision and after wound closure. There was no significant difference between digital breast volumes by intraoperative and outpatient 3DSI. Intraoperative pre- to postoperative 3D breast volume change showed no significant difference to the known implant volume (p = 0.124, mean deviation of 5.8 ± 24.3 mL and 2.0 ± 9.0%).
Our findings showed a high correlation regarding intraoperative digital breast volumetric changes. Intraoperative use of 3DSI yielded objective data during breast augmentation. This novel technique could beneficially impact future breast implant selection, especially in cases with breast asymmetry and the need for differently sized implants.
在美容和重建乳房手术中，乳房体积估计和植入物大小是实现对称结果的关键因素。尽管三维表面成像（3DSI）可以更好地了解乳房的形状、大小和不对称性，但在术中决策方面，其应用受到限制。
验证便携式手持 3D 表面成像设备在乳房隆乳术中作为评估体积变化的客观工具的术中使用。
本研究纳入了接受双侧胸肌下乳房隆乳术的患者。术中使用 Sense 3D 扫描仪进行 3DSI，允许对手术区域进行数字化。将由已知植入物体积引起的术中测量的容积变化与从手术野的 3D 表面图像计算出的数字测量值进行比较。将数字术中乳房体积与术前和术后的 Vectra XT 参考系统进行比较。
40 名患者的 80 个乳房在切口前和缝合后成功进行了 3D 成像。术中和门诊 3DSI 的数字乳房体积没有显著差异。术中术前到术后 3D 乳房体积变化与已知植入物体积无显著差异（p=0.124，平均偏差为 5.8±24.3 mL 和 2.0±9.0%）。
我们的研究结果表明，术中数字乳房体积变化相关性较高。3DSI 在乳房隆乳术中的应用可提供客观数据。这项新技术可能对未来的乳房植入物选择产生有益影响，特别是在乳房不对称和需要不同大小植入物的情况下。
