GMS German Plastic, Reconstructive and Aesthetic Surgery – Burn and Hand Surgery (Jun 2016)
Correlation of centroid-based breast size, surface-based breast volume, and asymmetry-score-based breast symmetry in three-dimensional breast shape analysis
Abstract
Objective: The aim of this study was to investigate correlations among the size, volume, and symmetry of the female breast after reconstruction based on previously published data. Methods: The centroid, namely the geometric center of a three-dimensional (3D) breast-landmark-based configuration, was used to calculate the size of the breast. The surface data of the 3D breast images were used to measure the volume. Breast symmetry was assessed by the Procrustes analysis method, which is based on the 3D coordinates of the breast landmarks to produce an asymmetry score. The relationship among the three measurements was investigated. For this purpose, the data of 44 patients who underwent unilateral breast reconstruction with an extended latissimus dorsi flap were analyzed. The breast was captured by a validated 3D imaging system using multiple cameras. Four landmarks on each breast and two landmarks marking the midline were used.Results: There was a significant positive correlation between the centroid-based breast size of the unreconstructed breast and the measured asymmetry (p=0.024; correlation coefficient, 0.34). There was also a significant relationship between the surface-based breast volume of the unaffected side and the overall asymmetry score (p<0.001; correlation coefficient, 0.556). An increase in size and especially in volume of the unreconstructed breast correlated positively with an increase in breast asymmetry in a linear relationship.Conclusions: In breast shape analysis, the use of more detailed surface-based data should be preferred to centroid-based size data. As the breast size increases, the latissimus dorsi flap for unilateral breast reconstruction increasingly falls short in terms of matching the healthy breast in a linear relationship. Other reconstructive options should be considered for larger breasts. Generally plastic surgeons should view the two breasts as a single unit when assessing breast aesthetics and not view each breast on its own.
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