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Three-Dimensional Surface Imaging in Plastic Surgery: Foundation, Practical Applications, and Beyond

Chang, Jessica B. B.S.; Small, Kevin H. M.D.; Choi, Mihye M.D.; Karp, Nolan S. M.D.

Plastic and Reconstructive Surgery: May 2015 - Volume 135 - Issue 5 - p 1295–1304
doi: 10.1097/PRS.0000000000001221
Cosmetic: Original Articles
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Summary: Three-dimensional surface imaging has gained clinical acceptance in plastic and reconstructive surgery. In contrast to computed tomography/magnetic resonance imaging, three-dimensional surface imaging relies on triangulation in stereophotography to measure surface x, y, and z coordinates. This study reviews the past, present, and future directions of three-dimensional topographic imaging in plastic surgery. Historically, three-dimensional imaging technology was first used in a clinical setting in 1944 to diagnose orthodontologic conditions. Karlan established its use in the field of plastic surgery in 1979, analyzing contours and documenting facial asymmetries. Present use of three-dimensional surface imaging has focused on standardizing patient topographic measurements to enhance preoperative planning and to improve postoperative outcomes. Various measurements (e.g., volume, surface area, vector distance, curvature) have been applied to breast, body, and facial topography to augment patient analysis. Despite the rapid progression of the clinical applications of three-dimensional imaging, current use of this technology is focused on the surgeon’s perspective and secondarily the patient’s perspective. Advancements in patient simulation may improve patient-physician communication, education, and satisfaction. However, a communal database of three-dimensional surface images integrated with emerging three-dimensional printing and portable information technology will validate measurements and strengthen preoperative planning and postoperative outcomes. Three-dimensional surface imaging is a useful adjunct to plastic and reconstructive surgery practices and standardizes measurements to create objectivity in a subjective field. Key improvements in three-dimensional imaging technology may significantly enhance the quality of plastic and reconstructive surgery in the near future.

New York, N.Y.

From the Department of Plastic Surgery, New York University Medical Center; and the Division of Plastic Surgery, New York–Presbyterian Hospital/Weill Cornell Medical College.

Received for publication June 26, 2014; accepted August 26, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Videos” tab to watch.

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

©2015American Society of Plastic Surgeons