Three-Dimensional Surface Imaging in Postoperative Volumetric Assessment of Implant-Only and Composite Breast...

Three-dimensional (3D) surface imaging is better validated for postoperative volume assessment in implant-only augmentation than in composite breast augmentation (CBA). In CBA, the extent to which anatomical features and biological variability contribute to volumetric deviation remains insufficiently defined.

This retrospective study included 94 patients (188 breasts) who underwent either implant-only augmentation (Group 0) or composite augmentation with fat grafting (Group 1). Breast volumes were measured with the Vectra XT system preoperatively and at 3 and 6 months postoperatively. Net postoperative volume gain was compared with implant volume, and both signed and absolute volumetric deviations were calculated. Mixed-effects and generalized estimating equation models were used to identify factors associated with deviation magnitude and direction.

Six-month postoperative breast volume was greater in the composite group than in the implant-only group (p = 0.0186). Signed volumetric deviation was significantly more negative in composite cases (p < 0.001). A net volume gain smaller than implant volume was observed in 20.9% of composite breasts and 48.0% of implant-only breasts (p < 0.001). Among breasts with a net gain smaller than implant volume, the median deviation magnitude was similar in both groups, at approximately 22 mL. Greater breast base width was independently associated with increased absolute volumetric deviation (p = 0.005), whereas intersternal distance influenced deviation direction but not deviation magnitude. Postoperative BMI change was also independently associated with signed volumetric deviation (p < 0.001). Agreement between 3- and 6-month measurements was high (ICC = 0.95).

Vectra XT showed stable postoperative volumetric tracking after implant-only breast augmentation and may also be useful for follow-up assessment in composite cases. In composite augmentation, variations from the theoretically expected volume appear to reflect biological variability in fat graft retention and anatomical footprint rather than instability of the imaging system.

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