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An Innovative Three-Dimensional Approach to Defining the Anatomical Changes Occurring after Short Scar-Medial Pedicle Reduction Mammaplasty

Tepper, Oren M. M.D.; Choi, Mihye M.D.; Small, Kevin B.A.; Unger, Jacob B.A.; Davidson, Edward M.B.B.S.; Rudolph, Lauren B.A.; Pritchard, Ashley B.A.; Karp, Nolan S. M.D.

Plastic and Reconstructive Surgery: June 2008 - Volume 121 - Issue 6 - p 1875-1885
doi: 10.1097/PRS.0b013e31817151db
Breast: Original Articles

Background: Three-dimensional photography of the breast offers new opportunities to advance the fields of aesthetic and reconstructive breast surgery. The following study investigates the use of three-dimensional imaging to assess changes in breast surface anatomy, volume, tissue distribution, and projection following medial pedicle reduction mammaplasty.

Methods: Preoperative and postoperative three-dimensional scans were obtained from patients undergoing short-scar medial pedicle breast reduction. Three-dimensional models were analyzed by topographical color maps, changes in the lowest point of the breast, surface measurements, and the point of maximal projection. Total breast volume and percentage volumetric tissue distribution in the upper and lower poles were also determined.

Results: Thirty patients underwent reduction mammaplasty (mean postoperative scan, 80 ± 5 days). Color maps highlighted the majority of spatial changes in the central, upper poles. Reduction mammaplasty resulted in a significant decrease in the anteroposterior projection of the breast (6.3 ± 0.2 postoperatively compared with 8.1 ± 0.2 cm preoperatively; p < 0.01). The point of maximal breast projection was elevated in the cranial-caudal direction (4.8 ± 0.4 cm; p < 0.01), with a corresponding elevation in the lowest point of the breast (4.8 ± 0.5 cm; p < 0.01). Volumetric three-dimensional measurements identified a significant change in percentage tissue distribution after reduction mammaplasty (45 ± 2 percent above the inframammary fold preoperatively versus 76 ± 2 percent postoperatively; p < 0.01).

Conclusions: This study is the first to demonstrate the technical feasibility and clinical utility of three-dimensional geometric data in medial pedicle breast reduction surgery. This novel approach suggests new opportunities to define long-term operative changes following various breast procedures.

New York, N.Y.

From the Institute of Reconstructive Plastic Surgery, New York University Medical Center.

Received for publication June 8, 2007; accepted October 22, 2007.

Nolan Karp, M.D.; 305 East 47th Street, Suite 1A; New York, N.Y. 10017;

Disclosure: None of the authors has any conflicts of interest to disclose.

©2008American Society of Plastic Surgeons