A Comparison Between Two-Dimensional and Three-Dimensional Endoscopic Imaging for Breast Augmentation.

Background This study aimed to compare the reoperation rates between two-dimensional (2D) and three-dimensional (3D) endoscopic imaging used for breast augmentation. Methodology The medical records of females who underwent primary or revision breast augmentation surgery at our clinic from January 2014 to December 2023 were retrospectively reviewed. From January 2016 to August 2022, endoscopic operations were performed under 2D imaging, and from September 2022 onward, operations were performed using a novel synthetic 3D imaging technique (Monostereo®). All operations were performed by the same surgeon. The reoperation rate and other study variables between the two groups were compared. Results A total of 351 female patients (median age = 33 years) were included, of whom 216 had surgery using 2D imaging and 135 had surgery using 3D imaging. The overall reoperation rate was 4.3% (15/351), and it was significantly lower in the 3D imaging group compared to the 2D imaging group (14/216 (6.5%) vs. 1/135 (0.7%); p = 0.01). Age, incision site, placement, implant surface type, or surgery time had no association with reoperation. However, patients who required reoperation had a significantly larger implant size (330 (300-360) mL) than those who did not require a reoperation (275 (270-325) mL) (p < 0.05). Capsular contracture was the reason for 60% (n = 9) of the reoperations, and 40% (n = 6) of the reoperations were a size change requested by the patients. Conclusions Breast augmentation using the novel synthetic 3D imaging technique is associated with a lower reoperation rate compared to conventional 2D imaging. Further investigation is needed to examine the benefits of 3D imaging for breast augmentation.