3-Dimensional Simulation for Breast Augmentation: Does the Software Actually Work?

Recent advances in 3-dimensional (3D) imaging, such as the Vectra XT 3D imaging system (Vectra; Canfield Imaging Systems), have enabled simulations for breast augmentation. These simulations are popular and valuable in preoperative consultations, but no studies have evaluated the system's predictive volume accuracy with a large sample size or explored the patient-specific and surgical factors influencing these simulations.

A prospective cohort study was conducted on patients undergoing breast augmentation simulations with Vectra between January of 2021 and December of 2022. Predictive volumetric accuracy was analyzed with a ±10% precision threshold and Bland-Altman visualization. Linear breast measurements were compared using mean and median absolute error analysis, and a generalized linear model with generalized estimating equations was used to identify factors affecting volume prediction accuracy.

The study included 78 patients (154 breasts). Accurate predictions (±10% error) were achieved in 73% of cases, with an average margin of error of 7.52%. The most accurate measurement was sternal-nipple ( P = 0.64) and the least accurate measurement was nipple-inframammary fold ( P = 0.001). Factors influencing prediction accuracy included pregnancy history, preoperative breast volume, and implant volume.

Vectra accurately predicts postoperative breast volumes within a 10% margin of error, although precision decreases with larger breasts (greater than 650 cc). Patient-specific factors, such as pregnancy history and preoperative breast characteristics, should guide preoperative consultations. The system enhances patient education, shared decision-making, and participation in care, reinforcing its value in preoperative planning for breast augmentation.