We would like to congratulate the authors of the article entitled “Surface Area Measurement of the Female Breast: Phase I. Validation of a Novel Optical Technique” (Plast Reconstr Surg. 2009:123;1588–1596) for the excellent scientific value of their report. However, there are some points that we would like to discuss. This is not the first study on breast surface area measurement. Our team has developed this issue over the years1,2 with either commercial optical scanners or experimental devices; an ad hoc software tool has also been developed and is available on the Internet (http://svg.dmi.unict.it/bsa/).
We must acknowledge that the study of Thomson et al. is one of the first entirely validated studies on optical three-dimensional breast assessment, whereas our studies are still in search of validation.
In accordance with Thomson et al., we believe that surface assessment, rather than volume, is the most important estimate in the evaluation of breast surgery outcome. We based the first steps of our investigation on the search for reliable parameters that can characterize the breast morphologic properties. The “surface area” is certainly one of these, although we found that the “Gaussian curvature” parameter can be a very promising one. For instance, it allows us to replace visual terminologies with numerical values (i.e., a surface with a positive curvature will appear round and “full,” and nearly flat surfaces will have curvature values close to zero and will appear “flat”) that can be quantitatively reevaluated over time to describe pathologic processes such as capsular contracture and consequent surface deformation.
Maurizio B. Nava
Unit of Plastic and Reconstructive Surgery
Istituto Nazionale dei Tumori
1. Catanuto G, Spano A, Pennati A, et al. Experimental methodology for digital breast shape analysis and objective surgical outcome evaluation. J Plast Reconstr Aesthet Surg
2. Farinella GM, Impoco G, Gallo G, Spoto S, Catanuto G, Nava MB. Objective outcome evaluation of breast surgery. Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv
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