"3D Simulation for Breast Augmentation: Does the software actually work?".

[BACKGROUND] Recent advancements in 3D imaging, such as the VECTRA XT 3D imaging system (Canfield Imaging Systems, Fairfield, N.J., USA), have enabled simulations for breast augmentation. While popular and valuable in preoperative consultations, no studies have evaluated the system's predictive volume accuracy with such a large sample size or explored the patient-specific and surgical factors influencing these simulations.

[METHODS] A prospective cohort study was conducted on patients undergoing breast augmentation simulations with the VECTRA 3D imaging system between January 2021 and December 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 identified factors affecting volume prediction accuracy.

[RESULTS] 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 was nipple-IMF (p=0.001). Factors influencing prediction accuracy included pregnancy history, preoperative breast volume, and implant volume.

[CONCLUSIONS] The VECTRA 3D system accurately predicts postoperative breast volumes within a 10% margin of error, though precision decreases with larger breasts (>650cc). 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.