Volumetric assessment using a three-dimensional imaging system in revision of breast reconstruction with deep inferior epigastric artery perforator flaps.

Abstract

Three-dimensional imaging systems are used in breast volume revision surgery. However, the utility of a three-dimensional imaging system for breast reduction after autologous breast reconstruction is yet to be reported. In this study, we retrospectively investigated the use of VECTRA® H1 (Canfield Scientific, Inc. NJ. USA.) three-dimensional image analysis to estimate the amount of tissue required for breast revision surgery after deep inferior epigastric artery perforator flap reconstruction. This retrospective study included patients who underwent reconstructive breast volume reduction surgery after reconstruction with a deep inferior epigastric artery perforator flap. We took three-dimensional images before and 6 months after surgery, and analyzed the consistency between the volume difference (apparent difference) after surgery and weight of the actual reduced tissue. The intraclass correlation coefficient [ICC(2,1) and ICC(2,k)] were 0.654 and 0.791 (p < 0.0001), respectively. The Bland-Altman plot yielded a bias of 2.28, with limits of agreement ranging from -85.4 to 89.96. A significant positive correlation was found between these values in a simple regression analysis (y = 0.547x + 34.72, R² = 0.43, p < 0.001). To our knowledge, this is the first study examining the accuracy of VECTRA® H1 for tissue reduction, including skin and fat. The difference in breast volume between the two sides assessed using VECTRA® H1 was consistent with the actual resection weights. Therefore, VECTRA® H1 could be a useful volumetric indicator for revision surgery after breast reconstruction using autologous tissue.