Optimizing Implant Width Selection in Breast Augmentation: Insights From On-Patient Landmark Positioning in 3-Dimensional Breast Simulation.

[BACKGROUND] The Vectra XT 3D simulation program is a valuable tool for implant selection during the decision-making process regarding breast augmentation. The software allows for the assignment of automatically or manually positioned anatomical landmarks and provides accompanying measurements.

[OBJECTIVES] This study aimed to present a strategy for standardizing landmark placement on Vectra images during primary breast augmentations, optimizing implant selection and ensuring consistency in breast width data collection.

[METHODS] The author performed a retrospective analysis of patient data in which breast width measurements were obtained through clinical assessment (CA) and the Vectra program with both automatically (VA) and manually (VM) placed landmarks. Consideration was also given to the thickness of medial and lateral breast tissues. The suggested implant base width from all groups was then compared to the actual implant placed during the surgical procedure.

[RESULTS] Comparing the change rates with the actual implant width revealed that rates in CA measurements were significantly lower than those in VA (P < .05), and similarly lower than those in VM (P < .05). Furthermore, change rates in VM were significantly lower than in VA (P < .05). Each group showed a significant positive correlation with the actual implant width.

[CONCLUSIONS] The Vectra XT 3D simulation program is a valuable adjunct in breast augmentation. However, relying on it solely may lead to inaccuracies in the assessment of breast dimensions due to automatic landmarking. To achieve standardized measurements, landmarks can be marked on the patient before creating the Vectra image. Our results underline the superiority of clinical judgment to simulation programs when establishing a reliable surgical plan.