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Three-Dimensional Simulated Images in Breast Augmentation Surgery: An Investigation of Patients’ Satisfaction and the Correlation between Prediction and Actual Outcome

Donfrancesco, Andrea M.D.; Montemurro, Paolo M.D.; Hedén, Per M.D., Ph.D.

Plastic and Reconstructive Surgery: October 2013 - Volume 132 - Issue 4 - p 810–822
doi: 10.1097/PRS.0b013e3182a014cb
Cosmetic: Original Articles
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Background: Breast augmentation is one of the most commonly performed operations. Three-dimensional outcome simulation can be used to predict and demonstrate for the patient what the planned operation aims to achieve in terms of size and shape. However, there are still few studies in the literature that look at how close the simulation is to the actual postoperative result and how patients perceive the accuracy and usefulness of the simulation.

Methods: A prospective series of 150 patients underwent breast augmentation following consultation with the aid of three-dimensional simulation images. These patients were evaluated with a questionnaire 6 months postoperatively. A retrospective chart review of 52 patients whose three-dimensional simulations were compared with the postoperative photographs were evaluated and graded by an independent panel of investigators.

Results: The independent panel graded the overall similarity of the three-dimensional simulations to the actual breasts with a total average score ± SD of 7.5 ± 0.80 (range, 4.5 to 8.9) using a visual analogue scale ranging from 1 to 10. The highest average score was given to projection, breast width, and height (7.8); the lowest average score was given to intermammary distance (7.0). Eighty-six percent of patients felt the simulated image was very accurate in predicting the actual result of their breasts.

Conclusions: Patients prefer a center that offers three-dimensional imaging technology; they feel that the simulation is very accurate and helps them very much in choosing the implant; if they could go back in time, they would choose the same implant again.


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Stockholm, Sweden

From Akademikliniken.

Received for publication March 21, 2013; accepted April 29, 2013.

Disclosure: Dr. Hedén is a member of the VECTRA XT Steering Committee, an international group of six plastic surgeons giving scientific advice on the development of Canfield’s coming generation of three-dimensional software. The other authors have no financial interest to declare in relation to the content of this article.

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Andrea Donfrancesco, M.D., Viale Cortina D’ Ampezzo 186, 00135 Rome, Italy,

©2013American Society of Plastic Surgeons