Aesthetic Plastic Surgery

, Volume 35, Issue 4, pp 494–501 | Cite as

Customized Planning of Augmentation Mammaplasty with Silicon Implants Using Three-Dimensional Optical Body Scans and Biomechanical Modeling of Soft Tissue Outcome

  • Evgeny GladilinEmail author
  • Barbora Gabrielova
  • Paolo Montemurro
  • Per Hedén
Original Article


The aesthetic results of augmentation mammaplasty are essentially determined by the size and the shape of the implant as well as its position on the chest. To achieve successful aesthetic results, customized surgery planning based on a reliable visual concept of the prospective surgery outcome and quantitative methods for assessment of three-dimensional (3D) breast shape could be of considerable additional value. This report evaluates a novel method for customized planning and quantitative optimization of breast augmentation based on 3D optical body scanning of the patient’s breast and computational modeling of soft tissue mechanics. This method allows a 3D photo-realistic appearance of postsurgery breasts to be simulated for different surgical scenarios. It also allows the result of a virtual simulation to be implemented using measurements derived from a computationally predicted breast model. A series of clinical studies are presented that demonstrate the feasibility and accuracy of the proposed approach for customized 3D planning of breast augmentation, including direct comparison between simulated and postsurgery results. Our experimental results show that for 89% of the breast surface, the average difference between the simulated and postsurgery breast models amounts to less than 1 mm. The presented method for customized planning of augmentation mammaplasty enables realistic prediction and quantitative optimization of postsurgery breast appearance. Based on individual 3D data and physical modeling, the described approach enables more accurate and reliable predictions of surgery outcomes than conventionally used photos of prior patients, drawings, or ad hoc data manipulation. Moreover, it provides precise quantitative data for bridging the gap between virtual simulation and real surgery.


Augmentation mammaplasty Biomechanical modeling Customized surgery planning 3D imaging Quantitative optimization Silicon implants 


  1. 1.
    Tebbetts JB (2006) Augmentation mammaplasty: quantitative tissue assessment and planning: surgery of the breast: principles and art, 2nd ed. Lippincott Williams and Wilkins, Philadelphia, PA, USA, pp 1261–1288Google Scholar
  2. 2.
    Hedén P (2006) Breast augmentation with anatomical, high cohesive silicon gel implants: surgery of the breast: principles and art, 2nd ed. Lippincott Williams and Wilkins, Philadelphia, PA, USA, pp 1344–1366Google Scholar
  3. 3.
    Cunningham BL (2005) Gel breast implants: where are we now? Post-market surveillance and other considerations. Presented at the 1st annual QMP aesthetic surgery symposium, St. Louis, MO, USA, 21–23 Oct 2005Google Scholar
  4. 4.
    Azar FS, Metaxas DN, Schnall MD (2001) A deformable finite-element model of the breast for predicting mechanical deformations under external perturbations. Acad Radiol 8:965–975PubMedCrossRefGoogle Scholar
  5. 5.
    Samani A, Bishop J, Yaffe M, Plewes D (2001) Biomechanical 3-D finite element modeling of the human breast using MRI data. IEEE Trans Med Imaging 20:271–279PubMedCrossRefGoogle Scholar
  6. 6.
    Tanner C, Schnabel J, Degenhard A, Castellano SA, Hayes C, Leach M, Rose D, Hill D, Hawkes D (2002) Validation of volume-preserving nonrigid registration: application to contrast-enhanced MR mammography. In: Proceedings of Medical Image Computing and Computer-Assisted Intervention (MICCAI). Lecture Notes in Computer Science 2489, pp 307–314Google Scholar
  7. 7.
    Pamplona DC, Alvim CA (2004) Breast reconstruction with expanders and implants: a numerical analysis. Artif Organs 28:353–356PubMedCrossRefGoogle Scholar
  8. 8.
    Ruiter N, Stotzka R (2006) Model-based registration of x-ray mammograms and MR images of the female breast. IEEE Trans Nucl Sci 53:204–211CrossRefGoogle Scholar
  9. 9.
    Chunga JH, Rajagopala V, Laursenb TA, Nielsena PMF, Nasha MP (2008) Frictional contact mechanics methods for soft materials: application to tracking breast cancers. J Biomech 41:69–77CrossRefGoogle Scholar
  10. 10.
    Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, Endlich M, Mueller A, Schwenzer-Zimmerer K, Papadopulos NA, Biemer E (2007) Comparison between the breast volume measurement using 3D surface imaging and classical techniques. Breast 16:137–145PubMedCrossRefGoogle Scholar
  11. 11.
    Catanutoa G, Spanoa A, Pennatia A, Riggioa E, Farinellab GM, Impococ G, Spotob S, Gallob G, Nava MB (2008) Experimental methodology for digital breast shape analysis and objective surgical outcome evaluation. J Plast Reconstr Aesthet Surg 61:314–318CrossRefGoogle Scholar
  12. 12.
    Kim Y, Lee K, Kim W (2008) 3D virtual simulator for breast plastic surgery. Comput Animat Virtual Worlds 19:515–526CrossRefGoogle Scholar
  13. 13.
    Tepper O (2009) 3D imaging for planning and analysis in aesthetic breast surgery. Plast Reconstr Surg 124:108–109Google Scholar
  14. 14.
    Gladilin E (2003) Biomechanical modeling of soft tissue. PhD thesis, Free University of BerlinGoogle Scholar
  15. 15.
    Gladilin E (2008) Individual prediction and optimization of breast augmentation using 3D scans and biomechanical simulation of soft tissue. In: Presented at Beauty Through Science (BTS). Akademikliniken’s fourth international aesthetic symposium, Stockholm, Sweden, 5–7 June 2008Google Scholar
  16. 16.
    Hedén P (2009) Breast augmentation. In: Eriksson G, Saunders P (eds) Plastic surgery. Elsevier, Amsterdam, Netherlands, pp 1561–1574Google Scholar
  17. 17.
    Hedén P (2009) Mastopexy augmentation with form stable breast implants. Clin Plast Surg 36:91–104PubMedCrossRefGoogle Scholar
  18. 18.
    Allergan Co (2007) The Rossetta study. Personal CommunicationGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010

Authors and Affiliations

  • Evgeny Gladilin
    • 1
    Email author
  • Barbora Gabrielova
    • 1
  • Paolo Montemurro
    • 2
  • Per Hedén
    • 2
  1. 1.Bona FormaMannheimGermany
  2. 2.AkademiklinikenStockholmSweden

Personalised recommendations