3D Breast Scanning in Plastic Surgery Utilizing Free iPhone LiDAR Application: Evaluation, Potential, and Limitations.

BACKGROUND

Three-dimensional (3D) imaging enhances surgical planning and documentation in plastic surgery, but high costs limit accessibility. Mobile light detection and ranging (LiDAR) technology offers a potential cost-effective alternative.

OBJECTIVES

The objective of this research was to evaluate the accuracy and clinical utility of iPhone-based LiDAR scanning for breast measurements compared to traditional methods, and to establish standardized protocols for clinical implementation.

METHODS

In this prospective validation study, 25 consecutive patients (mean age: 44 years; range: 32-64 years; mean BMI: 23.2 kg/m2) undergoing breast procedures were evaluated with the "3D Scanner App" on the iPhone 15 Pro (Apple Inc., Cupertino, CA). Three standardized measurements (sternal notch-to-nipple, nipple-to-midline, nipple-to-inframammary fold) of LiDAR and manual techniques were compared. Technical error of measurement (TEM) and relative TEM (rTEM) were calculated. Interrater reliability, learning curve assessment, and cost-effectiveness analysis were performed.

RESULTS

LiDAR measurements showed very good accuracy for sternal notch-to-nipple (rTEM 1.43%, 95% CI: 1.21-1.65) and nipple-to-midline (rTEM 2.83%, 95% CI: 3.12-3.78) distances. Nipple-to-inframammary fold measurements showed poor accuracy (rTEM 13.05%, 95% CI: 8.21-9.39). Interrater reliability was excellent (ICC = 0.92). Learning curve analysis demonstrated measurement stability after 5 cases. Cost analysis revealed 97.8% reduction in initial investment compared to commercial 3D imaging systems.

CONCLUSIONS

Mobile LiDAR offers a cost-effective tool for breast surgery planning and documentation. While measurements like sternum-to-nipple and nipple-to-midline are highly accurate, the relatively poor accuracy of nipple-to-IMF highlights limitations with complex curves. As this technology continues to evolve, further improvements in accuracy are anticipated, expanding its role in clinical use.