Summary
Background
The latissimus dorsi muscle flap is a common method for the reconstruction of the
breast following mastectomy. The study aimed to assess the quality of this reconstruction
using a three-dimensional (3D) imaging method. The null hypothesis was that there
was no difference in volume between the reconstructed breast and the opposite side.
Methods
This study was conducted in forty-four patients who had had immediate unilateral breast
reconstruction by latissimus dorsi muscle flap. The breast was captured using the
3D imaging system. Ten landmarks were digitised on the 3D images. The volume of each
breast was measured by the application of Breast Analysis Tool software. The symmetry
of the breast was measured using Procrustes analysis. The impact of breast position,
orientation, size and intrinsic shape on the overall breast asymmetry was investigated.
Results
The null hypothesis was rejected. The reconstructed breast showed a significantly
smaller volume when compared to the opposite side, p < 0.0001, a mean difference of 176.8 cc and 95% CI (103.5, 250.0). The shape and
the position of the reconstructed breast were the main contributing factors to the
measured asymmetry score.
Conclusions
3D imaging was efficient in evaluating the outcome of breast surgery. The latissimus
dorsi muscle flap on its own for breast reconstruction did not restore the volume
and shape of the breast fully lost due to complete mastectomy. The modification of
this method and the selection of other or additional surgical techniques for breast
reconstruction should be considered. The asymmetry analysis through reflection and
Procrustes matching was a useful method for the objective shape analysis of the female
breast and presented a new approach for breast shape assessment. The intrinsic breast
shape and the positioning of the breast were major components of postoperative breast
asymmetry. The reconstructed breast was smaller overall than the un-operated breast
at a significant level when assessing the breast volume using the surface area. 3D
imaging by multiple stereophotogrammetry was a useful tool for volume measurements,
shape analysis and the evaluation of symmetry.
Keywords
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Article info
Publication history
Published online: April 23, 2012
Accepted:
March 27,
2012
Received:
November 29,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
