Outcome analysis of virtual planning of DIEP flaps for breast reconstruction: virtual planning of DIEP Flaps.

Background. Accurate breast volume estimation is critical in planning and assessing outcomes of autologous breast reconstruction. Traditional techniques such as plaster casting, water displacement, and formula-based anthropometry have limitations in patient comfort, reproducibility, and accuracy. Computed tomography (CT) and magnetic resonance imaging (MRI) are accurate but resource-intensive, while 3D surface scanning offers a non-invasive and reproducible alternative.
Methods. This prospective study included 38 patients undergoing autologous breast reconstruction. Pre-operative breast and hemi-abdominal volumes were measured using CT.3D surface scanner was used to measure the pre-operative healthy breast and post-operative reconstructed breast volumes. Agreement between modalities was assessed using paired t-tests, Pearson’s correlation, and intraclass correlation coefficient (ICC). Post-operative satisfaction was analyzed using the BREAST-Q questionnaire at 3-6 months.
Results. The mean pre-operative breast volume was 721.1 ± 151.5cc on CT and 701.5 ± 121.5cc on 3D scanning, while the mean post-operative reconstructed breast volume was 762.0 ± 137.1cc. The mean hemiabdominal volume was 787.3 ± 134.0cc on CT. Strong correlations were observed between pre-operative CT and post-operative 3D breast volumes (r = 0.981, p < 0.0001), and between hemiabdominal CT volume and reconstructed breast volume (r = 0.917,p < 0.0001). No significant differences were found between CT and 3D scan measurements( p > 0.28). The ICC between CT and 3D volumes was 0.91(95% CI: 0.86-0.95), indicating excellent agreement. BREAST-Q analysis showed a negative correlation between breast volume asymmetry and satisfaction (r = –0.58, p = 0.0014).
Conclusions. 3D surface scanning exhibits excellent concordance with CT and serves as a reliable tool for predicting post-operative breast volume. It represents a valid, non-invasive tool for pre-operative planning and post-operative evaluation in breast reconstruction.