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Evaluating The Accuracy Of 3D Automated Photogrammetry: A Study Of Breast Anthropomorphic Measurements
Cristin Coquillard, MD, Mohamed Awad, MD, Anand Kumar, MD, Donald Harvey, MD.
Case Western Reserve University/University Hospitals, Cleveland, OH, USA.

PURPOSE: Three-dimensional (3D) photogrammetry has gained popularity in recent years in a variety of plastic surgery applications. While it has been well validated and studied in the face, few studies exist evaluating its potential use in breast surgery. Accurate and reliable breast measurements are critical in surgical planning for procedures such as breast reduction, mastopexy, augmentation, and reconstruction following mastectomy. The purpose of this study was to evaluate the accuracy of the Canfield Vectra XT imaging system in breast anthropomorphic measurements. We hypothesize that there is no difference between manual breast measurements and those calculated using the Vectra XT system.
METHODS: A retrospective chart review was performed using 11 adult patients undergoing breast surgery with a single surgeon. Pre-operative anthropomorphic measurements made using Mirror software (Canfield Scientific) analysis of 3D images were compared to measurements made in clinic by the attending surgeon, including sternal notch to nipple, inframammary fold (IMF) to nipple, and breast width. Patients' body mass indices (BMI) and cup size were also noted. A t-type analysis (IBM SPSS software) was used to determine if there was a difference between the computer based versus clinical measurements.
RESULTS: There was no statistically significant difference between software-generated measurements and clinical measurements in sternal notch to right nipple (p=0.18, mean difference 1.5cm, mean standard error (SE) 1%), sternal notch to left nipple (p=0.09, mean difference 1.6cm, mean SE 1%), right breast width (p=0.74, mean difference 1.1cm, mean SE 2%), and left breast width (p=0.73, mean difference 0.94cm, mean SE 2%). On the other hand, there was a statistically significant difference in the distances noted for IMF to left nipple (p=0.04, mean difference 1.7cm, mean SE 5%), and IMF to right nipple (p=0.01, mean difference 1.9cm, mean SE 6%). Of note, when IMF to right nipple measurements were separated into obese vs non-obese patients, only differences in measurements in obese patients (BMI ≥ 30) achieved significance (p=0.03) vs non-obese patients (p=0.28). Additionally, the data showed a significant difference in all parameters in patients with a cup size of D or larger (p=0.01).
CONCLUSION: Our study demonstrates that automated 3D photogrammetry is accurate when a 1.5cm or smaller error is acceptable in surgical planning in breast surgery in non-obese patients. Further study is needed to better elucidate the critical BMI in which accuracy falls within 5mm to 1cm to better predict surgical outcomes.


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