Three-Dimensional Scanning for Reduction Mammaplasty in Asymmetric Breast Hypertrophy.

BACKGROUND: Asymmetric breast hypertrophy is a common clinical presentation, primarily managed through surgical intervention. Accurate preoperative symmetry assessment is crucial for determining postoperative breast symmetry and aesthetic outcomes. However, current assessments rely heavily on surgeon experience, posing challenges for less experienced practitioners, and conventional measurement techniques fail to accurately capture bilateral breast volume and related parameters. In this study, three-dimensional (3D) scanning enabled rapid and straightforward preoperative assessment of breast morphology. This objective evaluation facilitated the optimization of postoperative breast symmetry. METHODS: A retrospective analysis was conducted on 25 female patients with asymmetric breast hypertrophy who underwent reduction mammaplasty in our department between February 2023 and February 2025. All patients underwent 3D breast scanning both preoperatively and at the 6-month postoperative follow-up. Bilateral breast volume difference and blinded observer-rated aesthetic scores were then analyzed based on the acquired data. Aesthetic evaluation of postoperative breast morphology was evaluated based on preoperative and postoperative photographs using a 5-point Likert scale (5 = excellent, 1 = poor). The assessment covered five key dimensions: (1) nipple-areola complex (NAC) position, (2) inframammary fold (IMF) height, (3) breast size, (4) breast shape, and (5) projection. RESULTS: All 25 patients underwent successful reduction mammaplasty. Breast volume was assessed via 3D scanning both preoperatively and at 6 months postoperatively. The mean postoperative follow-up duration was 6.85 ± 1.54 months. The mean preoperative volume asymmetry of 148.32 mL was reduced to 15.32 mL postoperatively, representing a mean reduction of 133.00 mL (95% CI: 102.13, 163.87; p < 0.001). Expressed as a percentage, the volume symmetry improved by a mean of 88.10% (95% CI: 86.03%, 90.16%), which was statistically significant compared to a null hypothesis of 0% improvement (p < 0.001). With the application of the 3D scanning technique, the average observer-rated aesthetic score postoperatively was 4.40 (on a 5-point scale). Postoperative symmetry scores across all five evaluated dimensions demonstrated significant improvement relative to preoperative baseline values (p < 0.001). CONCLUSION: In this single-surgeon, single-center case series, the implementation of 3D scanning-assisted preoperative planning was correlated with a reduction in breast volume asymmetry and an improvement in observer-rated aesthetic symmetry among patients presenting with asymmetric breast hypertrophy. These findings suggest that 3D scanning may provide objective data to assist less-experienced surgeons in decision-making regarding glandular tissue resection, potentially contributing to improved breast symmetry. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .