Skip to main content
Top
Published in: Aesthetic Plastic Surgery 4/2012

01-08-2012 | Original Article

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

Authors: Laszlo Kovacs, Maximilian Eder, Alexander Zimmermann, Daniel Müller, Tibor Schuster, Nikolaos A. Papadopulos, Edgar Biemer, Markus Klöppel, Hans-Günther Machens

Published in: Aesthetic Plastic Surgery | Issue 4/2012

Login to get access

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.
Literature
1.
go back to reference Hedén P, Jernbeck J, Hober M (2001) Breast augmentation with anatomical cohesive gel implants: the world’s largest current experience. Clin Plast Surg 28:531–552PubMed Hedén P, Jernbeck J, Hober M (2001) Breast augmentation with anatomical cohesive gel implants: the world’s largest current experience. Clin Plast Surg 28:531–552PubMed
2.
go back to reference Young VL, Nemecek JR, Nemecek DA (1994) The efficacy of breast augmentation: breast size increase, patient satisfaction, and psychological effects. Plast Reconstr Surg 94:958–969PubMedCrossRef Young VL, Nemecek JR, Nemecek DA (1994) The efficacy of breast augmentation: breast size increase, patient satisfaction, and psychological effects. Plast Reconstr Surg 94:958–969PubMedCrossRef
3.
go back to reference Galdino GM, Nahabedian M, Chiaramonte M, Geng JZ, Klatsky S, Manson P (2002) Clinical applications of three-dimensional photography in breast surgery. Plast Reconstr Surg 110:58–70PubMedCrossRef Galdino GM, Nahabedian M, Chiaramonte M, Geng JZ, Klatsky S, Manson P (2002) Clinical applications of three-dimensional photography in breast surgery. Plast Reconstr Surg 110:58–70PubMedCrossRef
4.
go back to reference Ferreira MC (2000) Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty. Plast Reconstr Surg 106:1630–1635PubMedCrossRef Ferreira MC (2000) Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty. Plast Reconstr Surg 106:1630–1635PubMedCrossRef
5.
go back to reference Tepper OM, Unger JG, Small KH, Feldman D, Kumar N, Choi M, Karp NS (2010) Mammometrics: the standardization of aesthetic and reconstructive breast surgery. Plast Reconstr Surg 125:393–400PubMedCrossRef Tepper OM, Unger JG, Small KH, Feldman D, Kumar N, Choi M, Karp NS (2010) Mammometrics: the standardization of aesthetic and reconstructive breast surgery. Plast Reconstr Surg 125:393–400PubMedCrossRef
6.
go back to reference Chavoin JP, Teysseyre A, Grolleau JL (2005) Morphobreast: patient’s data bank management for objective selection of implant’s volume in hypotrophic breasts. Ann Chir Plast Esthet 50:487–493PubMedCrossRef Chavoin JP, Teysseyre A, Grolleau JL (2005) Morphobreast: patient’s data bank management for objective selection of implant’s volume in hypotrophic breasts. Ann Chir Plast Esthet 50:487–493PubMedCrossRef
7.
go back to reference Smith DJ Jr, Palin WE Jr, Katch VL, Bennett JE (1986) Breast volume and anthropomorphic measurements: normal values. Plast Reconstr Surg 78:331–335PubMedCrossRef Smith DJ Jr, Palin WE Jr, Katch VL, Bennett JE (1986) Breast volume and anthropomorphic measurements: normal values. Plast Reconstr Surg 78:331–335PubMedCrossRef
8.
go back to reference Westreich M (1997) Anthropomorphic breast measurement: protocol and results in 50 women with aesthetically perfect breasts and clinical application. Plast Reconstr Surg 100:468–479PubMedCrossRef Westreich M (1997) Anthropomorphic breast measurement: protocol and results in 50 women with aesthetically perfect breasts and clinical application. Plast Reconstr Surg 100:468–479PubMedCrossRef
9.
go back to reference Bouman FG (1970) Volumetric measurement of the human breast and breast tissue before and during mammaplasty. Br J Plast Surg 23:263–264PubMedCrossRef Bouman FG (1970) Volumetric measurement of the human breast and breast tissue before and during mammaplasty. Br J Plast Surg 23:263–264PubMedCrossRef
10.
go back to reference Schultz RC, Dolezal RF, Nolan J (1986) Further applications of Archimedes’ principle in the correction of asymmetrical breasts. Ann Plast Surg 16:98–101PubMedCrossRef Schultz RC, Dolezal RF, Nolan J (1986) Further applications of Archimedes’ principle in the correction of asymmetrical breasts. Ann Plast Surg 16:98–101PubMedCrossRef
11.
go back to reference Ingleby H (1949) Changes in breast volume in a group of normal young women. Bull Int Assoc Med Mus 29:87–92 Ingleby H (1949) Changes in breast volume in a group of normal young women. Bull Int Assoc Med Mus 29:87–92
12.
go back to reference Campaigne BN, Katch VL, Freedson P, Sady S, Katch FI (1979) Measurement of breast volume in females: description of a reliable method. Ann Hum Biol 6:363–367PubMedCrossRef Campaigne BN, Katch VL, Freedson P, Sady S, Katch FI (1979) Measurement of breast volume in females: description of a reliable method. Ann Hum Biol 6:363–367PubMedCrossRef
13.
go back to reference Kalbhen CL, McGill JJ, Fendley PM, Corrigan KW, Angelats J (1999) Mammographic determination of breast volume: comparing different methods. AJR Am J Roentgenol 173:1643–1649PubMed Kalbhen CL, McGill JJ, Fendley PM, Corrigan KW, Angelats J (1999) Mammographic determination of breast volume: comparing different methods. AJR Am J Roentgenol 173:1643–1649PubMed
14.
go back to reference Rudolph R, Forcier N (2009) Calculation of silicone breast implant volumes using breast magnetic resonance imaging. Aesthet Surg J 29:310–313PubMedCrossRef Rudolph R, Forcier N (2009) Calculation of silicone breast implant volumes using breast magnetic resonance imaging. Aesthet Surg J 29:310–313PubMedCrossRef
15.
go back to reference Pozzobon AV, Sabino Neto M, Veiga DF, Abla LE, Pereira JB, Biasi TL, Ferreira LM, Yamashita LA, Kawano F, Nakano EM, Shigueoka DC (2009) Magnetic resonance images and linear measurements in the surgical treatment of breast asymmetry. Aesth Plast Surg 33:196–203CrossRef Pozzobon AV, Sabino Neto M, Veiga DF, Abla LE, Pereira JB, Biasi TL, Ferreira LM, Yamashita LA, Kawano F, Nakano EM, Shigueoka DC (2009) Magnetic resonance images and linear measurements in the surgical treatment of breast asymmetry. Aesth Plast Surg 33:196–203CrossRef
16.
go back to reference Nipshagen MD, Beekman WH, Esmé DL, de Becker J (2007) Anatomically shaped breast prosthesis in vivo: a change of dimension? Aesth Plast Surg 31:540–543CrossRef Nipshagen MD, Beekman WH, Esmé DL, de Becker J (2007) Anatomically shaped breast prosthesis in vivo: a change of dimension? Aesth Plast Surg 31:540–543CrossRef
19.
go back to reference Grossman AJ, Roudner LA (1980) A simple means for accurate breast volume determination. Plast Reconst Surg 66:851–852PubMedCrossRef Grossman AJ, Roudner LA (1980) A simple means for accurate breast volume determination. Plast Reconst Surg 66:851–852PubMedCrossRef
20.
go back to reference Brody GS (1981) Breast implant size selection and patient satisfaction. Plast Reconstr Surg 68:611–613PubMedCrossRef Brody GS (1981) Breast implant size selection and patient satisfaction. Plast Reconstr Surg 68:611–613PubMedCrossRef
21.
go back to reference Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Endlich M, Mueller A, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E (2007) Comparison between breast volume measurement using 3D surface imaging and classical techniques. Breast 16:137–145PubMedCrossRef Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Endlich M, Mueller A, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E (2007) Comparison between breast volume measurement using 3D surface imaging and classical techniques. Breast 16:137–145PubMedCrossRef
22.
go back to reference Bulstrode N, Bellamy E, Shrotria S (2001) Breast volume assessment: comparing five different techniques. Breast 10:117–123PubMedCrossRef Bulstrode N, Bellamy E, Shrotria S (2001) Breast volume assessment: comparing five different techniques. Breast 10:117–123PubMedCrossRef
23.
go back to reference Tebbetts JB (2002) A system for breast implant selection based on patient tissue characteristics and implant—soft tissue dynamics. Plast Reconstr Surg 109:1396–1409PubMedCrossRef Tebbetts JB (2002) A system for breast implant selection based on patient tissue characteristics and implant—soft tissue dynamics. Plast Reconstr Surg 109:1396–1409PubMedCrossRef
24.
go back to reference Tebbetts JB, Adams WP (2005) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high-five decision support process. Plast Reconstr Surg 116:2005–2016PubMed Tebbetts JB, Adams WP (2005) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high-five decision support process. Plast Reconstr Surg 116:2005–2016PubMed
25.
go back to reference Adams WP (2007) The high-five process: tissue-based planning for breast augmentation. Plast Surg Nurs 27:197–201PubMed Adams WP (2007) The high-five process: tissue-based planning for breast augmentation. Plast Surg Nurs 27:197–201PubMed
27.
go back to reference Tepper OM, Small KH, Unger JG, Feldman DL, Kumar N, Choi M, Karp NS (2009) 3D analysis of breast augmentation defines operative changes and their relationship to implant dimensions. Ann Plast Surg 62:570–575PubMedCrossRef Tepper OM, Small KH, Unger JG, Feldman DL, Kumar N, Choi M, Karp NS (2009) 3D analysis of breast augmentation defines operative changes and their relationship to implant dimensions. Ann Plast Surg 62:570–575PubMedCrossRef
28.
go back to reference Esme DL, Bucksch A, Beekman WH (2009) Three-dimensional laser imaging as a valuable tool for specifying changes in breast shape after augmentation mammaplasty. Aesth Plast Surg 33:191–195CrossRef Esme DL, Bucksch A, Beekman WH (2009) Three-dimensional laser imaging as a valuable tool for specifying changes in breast shape after augmentation mammaplasty. Aesth Plast Surg 33:191–195CrossRef
29.
go back to reference Eder M, Papadopulos NA, Kovacs L (2007) Re: virtual 3-dimensional modeling as a valuable adjunct to aesthetic and reconstructive breast surgery. Am J Surg 194:563–565PubMedCrossRef Eder M, Papadopulos NA, Kovacs L (2007) Re: virtual 3-dimensional modeling as a valuable adjunct to aesthetic and reconstructive breast surgery. Am J Surg 194:563–565PubMedCrossRef
30.
go back to reference Eder M, Waldenfels FV, Sichtermann M, Schuster T, Papadopulos NA, Machens HG, Biemer E, Kovacs L (2011) Three-dimensional evaluation of breast contour and volume changes following subpectoral augmentation mammaplasty over 6 months. J Plast Reconstr Aesthet Surg 64:1495–1502 Eder M, Waldenfels FV, Sichtermann M, Schuster T, Papadopulos NA, Machens HG, Biemer E, Kovacs L (2011) Three-dimensional evaluation of breast contour and volume changes following subpectoral augmentation mammaplasty over 6 months. J Plast Reconstr Aesthet Surg 64:1495–1502
31.
go back to reference Kovacs L, Eder M, Papadopulos NA, Biemer E (2005) Validating 3-dimensional imaging of the breast. Ann Plast Surg 55:695–696PubMedCrossRef Kovacs L, Eder M, Papadopulos NA, Biemer E (2005) Validating 3-dimensional imaging of the breast. Ann Plast Surg 55:695–696PubMedCrossRef
32.
go back to reference Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Udosic K, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E (2006) New aspects of breast volume measurement using 3-dimensional surface imaging. Ann Plast Surg 57:602–610PubMedCrossRef Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Udosic K, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E (2006) New aspects of breast volume measurement using 3-dimensional surface imaging. Ann Plast Surg 57:602–610PubMedCrossRef
33.
go back to reference Eder M, Schneider A, Feussner H, Zimmermann A, Höhnke C, Papadopulos NA, Kovacs L (2008) Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging. Biomed Tech 53:112–121CrossRef Eder M, Schneider A, Feussner H, Zimmermann A, Höhnke C, Papadopulos NA, Kovacs L (2008) Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging. Biomed Tech 53:112–121CrossRef
34.
go back to reference Kovacs L, Yassouridis A, Zimmermann A, Brockmann G, Wöhnl A, Blaschke M, Eder M, Schwenzer-Zimmerer K, Rosenberg R, Papadopulos NA, Biemer E (2006) Optimization of 3-dimensional imaging of the breast region with 3-dimensional laser scanners. Ann Plast Surg 56:229–236PubMedCrossRef Kovacs L, Yassouridis A, Zimmermann A, Brockmann G, Wöhnl A, Blaschke M, Eder M, Schwenzer-Zimmerer K, Rosenberg R, Papadopulos NA, Biemer E (2006) Optimization of 3-dimensional imaging of the breast region with 3-dimensional laser scanners. Ann Plast Surg 56:229–236PubMedCrossRef
35.
go back to reference Losken A, Seify H, Denson DD, Paredes AA Jr, Carlson GW (2005) Validating three-dimensional imaging of the breast. Ann Plast Surg 54:471–476PubMedCrossRef Losken A, Seify H, Denson DD, Paredes AA Jr, Carlson GW (2005) Validating three-dimensional imaging of the breast. Ann Plast Surg 54:471–476PubMedCrossRef
36.
go back to reference Cárdenas-Camarena L, Encinas-Brambila J (2009) Round gel breast implants or anatomic gel breast implants: which is the best choice? Aesth Plast Surg 33:743–751CrossRef Cárdenas-Camarena L, Encinas-Brambila J (2009) Round gel breast implants or anatomic gel breast implants: which is the best choice? Aesth Plast Surg 33:743–751CrossRef
37.
go back to reference Hamas RS (1999) The postoperative shape of round and teardrop saline-filled breast implants. Aesthet Surg J 5:369–374CrossRef Hamas RS (1999) The postoperative shape of round and teardrop saline-filled breast implants. Aesthet Surg J 5:369–374CrossRef
38.
go back to reference Hidalgo DA (2000) Breast augmentation: choosing the optimal incision, implant, and pocket plane. Plast Reconstr Surg 105:2202–2216PubMedCrossRef Hidalgo DA (2000) Breast augmentation: choosing the optimal incision, implant, and pocket plane. Plast Reconstr Surg 105:2202–2216PubMedCrossRef
39.
go back to reference Friedman T, Davidovitch N, Scheflan M (2006) Comparative double-blind clinical study on round versus shaped cohesive gel implants. Aesthet Surg J 26:530–536PubMedCrossRef Friedman T, Davidovitch N, Scheflan M (2006) Comparative double-blind clinical study on round versus shaped cohesive gel implants. Aesthet Surg J 26:530–536PubMedCrossRef
40.
41.
go back to reference Hall-Findlay EJ (2010) The three breast dimensions: analysis and effecting change. Plast Reconstr Surg 125:1632–1642PubMedCrossRef Hall-Findlay EJ (2010) The three breast dimensions: analysis and effecting change. Plast Reconstr Surg 125:1632–1642PubMedCrossRef
42.
go back to reference Vandeput JJ, Nelissen M (2002) Considerations on anthropometric measurements of the female breast. Aesth Plast Surg 26:348–355CrossRef Vandeput JJ, Nelissen M (2002) Considerations on anthropometric measurements of the female breast. Aesth Plast Surg 26:348–355CrossRef
43.
go back to reference Vandeput JJ (2006) Predictibility in breast augmentation. Eur J Plast Surg 28:451–457CrossRef Vandeput JJ (2006) Predictibility in breast augmentation. Eur J Plast Surg 28:451–457CrossRef
44.
go back to reference Eder M, Waldenfels FV, Swobodnik A, Klöppel M, Pape AK, Schuster T, Raith S, Kitzler E, Papadopulos NA, Machens HG, Kovacs L (2012) Objective breast symmetry evaluation using 3-D surface imaging. Breast 21:152–158PubMedCrossRef Eder M, Waldenfels FV, Swobodnik A, Klöppel M, Pape AK, Schuster T, Raith S, Kitzler E, Papadopulos NA, Machens HG, Kovacs L (2012) Objective breast symmetry evaluation using 3-D surface imaging. Breast 21:152–158PubMedCrossRef
Metadata
Title
Three-Dimensional Evaluation of Breast Augmentation and the Influence of Anatomic and Round Implants on Operative Breast Shape Changes
Authors
Laszlo Kovacs
Maximilian Eder
Alexander Zimmermann
Daniel Müller
Tibor Schuster
Nikolaos A. Papadopulos
Edgar Biemer
Markus Klöppel
Hans-Günther Machens
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Aesthetic Plastic Surgery / Issue 4/2012
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-012-9892-3

Other articles of this Issue 4/2012

Aesthetic Plastic Surgery 4/2012 Go to the issue