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Three-Dimensional Evaluation of Breast Augmentation and the Influence of Anatomic and Round Implants on Operative Breast Shape Changes

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Abstract

Background

Currently, postoperative outcome analysis in breast augmentation is essentially subjective, and objective evaluation of treatment efficacy is lacking. This study evaluates the influence of anatomic and round implant parameters on breast contour changes after subpectoral breast augmentation using three-dimensional (3D) surface imaging.

Methods

3D surface breast scans of 17 patients (34 breasts) undergoing subpectoral breast augmentation with round implants and of ten patients (20 breasts) receiving anatomic implants via an axillary approach under endoscopic assistance or a submammary fold incision were obtained before and 6 months postoperatively. 3D linear distance, breast volume, and surface measurement were correlated with the implanted round and anatomic implant parameters, and the resulting breast shape changes were evaluated.

Results

Total breast volume changed in correlation with the implant size (2.4 % difference; r = 0.894; p < 0.001). Implant volume and type influence the nipple-to-inframammary fold distance (N-IMF). Every inserted 100 ml implant volume enlarges the N-IMF distance by 0.8 cm (anatomic > round; p = 0.01). Postoperatively, the IMF dropped by an average of 1.3 cm for round implants and by 1.1 cm for anatomic implants, without relevant differences between the applied surgical incision and the selected implants (p > 0.05). Breast projection increased significantly more with anatomic implants (2.4 cm) than with round implants (1.7 cm) (p = 0.01). The breast projection increase was 22 % less than expected for round implants and 25 % less than expected for anatomic implants based on the manufacturer implant parameters (p < 0.01), without essential differences regarding the surgical incision.

Conclusions

3D breast shape changes induced by round and anatomic implants after subpectoral augmentation mammaplasty are objectively documented including breast projection, volume, and N-IMF distance changes. 3D surface imaging may have a potential clinical contribution to objective surgical outcome research.

Level of Evidence III

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 at www.springer.com/00266.

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Acknowledgments

The authors thank Prof. Dr. A. Haase, Director of the Institute of Medical Engineering (IMETUM), Technische Universität München, Germany for his cooperation and infrastructural support. In addition, they thank the whole medical staff of the Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Germany involved in the surgical treatment of the study patients.

Conflict of interest

The authors declare that they have no conflict of interest

Author information

Authors and Affiliations

  1. Department of Plastic Surgery and Hand Surgery, Research Group CAPS—Computer Aided Plastic Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany

    Laszlo Kovacs, Maximilian Eder, Daniel Müller, Nikolaos A. Papadopulos & Hans-Günther Machens

  2. Department of Vascular Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany

    Alexander Zimmermann

  3. Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany

    Tibor Schuster

  4. Clinic Plastic Surgery Munich, Maximilianstraße 54, 80538, Munich, Germany

    Edgar Biemer

  5. Private Practice Clinic of Esthetic Surgery, MediCenter München-Solln, Wolfratshauser Straße 216, 81479, München-Solln, Germany

    Markus Klöppel

Authors
  1. Laszlo Kovacs
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  2. Maximilian Eder
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  3. Alexander Zimmermann
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  4. Daniel Müller
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  5. Tibor Schuster
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  6. Nikolaos A. Papadopulos
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  7. Edgar Biemer
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  8. Markus Klöppel
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  9. Hans-Günther Machens
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Corresponding author

Correspondence to Laszlo Kovacs.

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Kovacs, L., Eder, M., Zimmermann, A. et al. Three-Dimensional Evaluation of Breast Augmentation and the Influence of Anatomic and Round Implants on Operative Breast Shape Changes. Aesth Plast Surg 36, 879–887 (2012). https://doi.org/10.1007/s00266-012-9892-3

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  • DOI: https://doi.org/10.1007/s00266-012-9892-3

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