Background: Breast reconstruction is an important coping tool for patients undergoing a mastectomy. There are numerous surgical techniques in breast reconstruction surgery (BRS). Regardless of the technique used, creating a symmetric outcome is crucial for patients and plastic surgeons. Three-dimensional surface imaging enables surgeons and patients to assess the outcome’s symmetry in BRS. To discriminate between autologous and alloplastic techniques, we analyzed both techniques using objective optical computerized symmetry analysis. Software was developed that enables clinicians to assess optical breast symmetry using three-dimensional surface imaging. Methods: Twenty-seven patients who had undergone autologous (n = 12) or alloplastic (n = 15) BRS received three-dimensional surface imaging. Anthropomorphic data were collected digitally using semiautomatic measurements and automatic measurements. Automatic measurements were taken using the newly developed software. To quantify symmetry, a Symmetry Index is proposed. Results: Statistical analysis revealed that there is no difference in the outcome symmetry between the two groups (t test for independent samples; p = 0.48, two-tailed). Conclusion: This study’s findings provide a foundation for qualitative symmetry assessment in BRS using automatized digital anthropometry. In the present trial, no difference in the outcomes’ optical symmetry was detected between autologous and alloplastic approaches. Level of evidence Level IV. Level of Evidence IV: 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.

Purpose: In this trial, we used a previously developed prototype software to assess aesthetic results after reconstructive surgery for congenital breast asymmetry using automated anthropometry. To prove the consensus between the manual and automatic digital measurements, we evaluated the software by comparing the manual and automatic measurements of 46 breasts. Methods: Twenty-three patients who underwent reconstructive surgery for congenital breast asymmetry at our institution were examined and underwent 3D surface imaging. Per patient, 14 manual and 14 computer-based anthropometric measurements were obtained according to a standardized protocol. Manual and automatic measurements, as well as the previously proposed Symmetry Index (SI), were compared. Results: The Wilcoxon signed-rank test revealed no significant differences in six of the seven measurements between the automatic and manual assessments. The SI showed robust agreement between the automatic and manual methods. Conclusion: The present trial validates our method for digital anthropometry. Despite the discrepancy in one measurement, all remaining measurements, including the SI, showed high agreement between the manual and automatic methods. The proposed data bring us one step closer to the long-term goal of establishing robust instruments to evaluate the results of breast surgery. Level of evidence: IV.

The utilization of three-dimensional (3D) surface imaging for facial anthropometry is a significant asset for patients undergoing maxillofacial surgery. Notably, there have been recent advancements in smartphone technology that enable 3D surface imaging.In this study, anthropometric assessments of the face were performed using a smartphone and a sophisticated 3D surface imaging system. 30 healthy volunteers (15 females and 15 males) were included in the study. An iPhone 14 Pro (Apple Inc., USA) using the application 3D Scanner App (Laan Consulting Corp., USA) and the Vectra M5 (Canfield Scientific, USA) were employed to create 3D surface models. For each participant, 19 anthropometric measurements were conducted on the 3D surface models. Subsequently, the anthropometric measurements generated by the two approaches were compared. The statistical techniques employed included the paired t-test, paired Wilcoxon signed-rank test, Bland-Altman analysis, and calculation of the intraclass correlation coefficient (ICC). All measurements showed excellent agreement between smartphone-based and Vectra M5-based measurements (ICC between 0.85 and 0.97). Statistical analysis revealed no statistically significant differences in the central tendencies for 17 of the 19 linear measurements. Despite the excellent agreement found, Bland-Altman analysis revealed that the 95% limits of agreement between the two methods exceeded ±3 mm for the majority of measurements. Digital facial anthropometry using smartphones can serve as a valuable supplementary tool for surgeons, enhancing their communication with patients. However, the proposed data suggest that digital facial anthropometry using smartphones may not yet be suitable for certain diagnostic purposes that require high accuracy.

Purpose: This study aimed to clarify the applicability of smartphone-based three-dimensional (3D) surface imaging for clinical use in oral and maxillofacial surgery, comparing two smartphone-based approaches to the gold standard. Methods: Facial surface models (SMs) were generated for 30 volunteers (15 men, 15 women) using the Vectra M5 ( Canfield Scientific, USA ), the TrueDepth camera of the iPhone 14 Pro ( Apple Inc., USA ), and the iPhone 14 Pro with photogrammetry. Smartphone-based SMs were superimposed onto Vectra-based SMs. Linear measurements and volumetric evaluations were performed to evaluate surface-to-surface deviation. To assess inter-observer reliability, all measurements were performed independently by a second observer. Statistical analyses included Bland–Altman analyses, the Wilcoxon signed-rank test for paired samples, and Intraclass correlation coefficients. Results: Photogrammetry-based SMs exhibited an overall landmark-to-landmark deviation of M = 0.8 mm (SD = ± 0.58 mm, n = 450), while TrueDepth-based SMs displayed a deviation of M = 1.1 mm (SD = ± 0.72 mm, n = 450). The mean volumetric difference for photogrammetry-based SMs was M = 1.8 cc (SD = ± 2.12 cc, n = 90), and M = 3.1 cc (SD = ± 2.64 cc, n = 90) for TrueDepth-based SMs. When comparing the two approaches, most landmark-to-landmark measurements demonstrated 95% Bland–Altman limits of agreement (LoA) of ≤ 2 mm. Volumetric measurements revealed LoA > 2 cc. Photogrammetry-based measurements demonstrated higher inter-observer reliability for overall landmark-to-landmark deviation. Conclusion: Both approaches for smartphone-based 3D surface imaging exhibit potential in capturing the face. Photogrammetry-based SMs demonstrated superior alignment and volumetric accuracy with Vectra-based SMs than TrueDepth-based SMs.

Digital anthropometry is a useful tool for surgeons and patients in breast reconstruction surgery (BRS). Owing to advancements in smartphone technology, these devices can be used for three-dimensional (3D) surface imaging. In this prospective study, anthropometric measurements of the breast were performed using a smartphone and compared with measurements obtained using an established 3D surface imaging system. In this study, 40 patients who underwent BRS were included. 3D-surface models (SMs) were obtained using the Vectra H2 stereophotogrammetry camera (Canfield Scientific, USA) and an iPhone 15 (Apple Inc., USA) in combination with the 3D Scanner App (Laan Consulting Corp., USA). Fourteen measurements were performed on all 3D SMs. Subsequently, smartphone-based measurements were compared to Vectra-based measurements. Statistical methods used were the paired t-test, paired Wilcoxon-signed ranks test, Bland-Altman analyses, and calculation of the intraclass correlation coefficient (ICC). All measurements demonstrated excellent agreement between those obtained using the smartphone and Vectra H2 (ICC between.963 and.998). No statistical differences were found for 11 of the 14 anthropometric measurements. The Bland-Altman analyses yielded promising results, demonstrating 95% limits of agreement within a range of less than ±2 mm between the 2 methods. The proposed method for smartphone-based anthropometry of the breast showed moderate accuracy for clinical use. However, the approach used to create and evaluate the 3D SMs is considered laborious. Therefore, further refinement of the method may be necessary to enable the implementation of smartphone-based surface imaging in plastic surgery. DRKS00034221.

Background: Thanks to 3D imaging, it is possible to measure the influence of different parameters on breast augmentation. In this study, we compare the effect of different shapes and sizes of breast implants on the topography of the resulting breast. Furthermore, the impact of different breast implants on inter-landmark distances and on changes of the nipple position was assessed. Methods: This interventional prospective study was carried out on 10 female patients after collecting informed consent. 3D scans of the native and augmented breasts were performed intraoperatively with small, medium, and large sizes of both anatomical and round implants, resulting in a total of n = 130 single breast scans. These scans were analyzed for topographic shift quantification, nipple migration, and inter-landmark distances of the breast. Results: Implant size, but not implant shape leads to significant topographic shifts of the breast (p < 0.001 and p = 0.900, respectively). Both round and anatomical implants lead to a significantly higher volumetric increase in the upper quadrants compared to the lower quadrants (p < 0.001). Nipple migration into the superomedial quadrant was seen in about 90% of augmentations. No evident differences in inter-landmark distances were observed when round and anatomical implants of different sizes were compared. Conclusions: Implant size rather than shape influences the postoperative aesthetic results. No significant difference in topographic shift was found comparing round and anatomical implants, suggesting that both implant shapes result in comparable aesthetic outcomes.