title: Four-dimensional breast imaging, part II: clinical implementation and validation of a computer imaging system for breast augmentation planning.
abstract: BACKGROUND
  No publications exist describing the impact of three-dimensional imaging on the consultation process for breast augmentation, nor have existing software products claiming simulation features been validated.
  
  
  OBJECTIVE
  The authors describe the application of four-dimensional technology during patient consultation to assist in planning implant size and type.
  
  
  METHODS
  Forty-six primary breast augmentation patients underwent preoperative consultation with 4D simulation software; 35 out of 46 also received follow-up imaging. At six months postoperatively, simulated measurements were compared to actual measurements and questionnaires were mailed to patients asking them to assess the imaging experience. A follow-up phone survey 18 months postoperatively examined the persistence of patient attitudes about implant size and imaging. Practice productivity was evaluated by comparing specific parameters (such as scheduling rates) between three separate time periods for the same clinic.
  
  
  RESULTS
  Across all parameters, breast augmentation simulations correlated highly with positive surgical outcomes (R-value = 0.68). The majority (95%) of patients believed the simulations were accurate; 89% also expressed that it enhanced trust in the surgeon and 74% reporting that it helped in choosing an implant size. Despite 48% also indicating that they would select a larger implant if they were to undergo surgery again, no patients have undergone reoperations of any kind. Compared to historical controls, scheduling rates in the practice increased from 40% to 77% after addition of simulation software.
  
  
  CONCLUSIONS
  4D breast imaging appears to be an accurate system for analysis, planning, simulation, and patient education for women considering primary breast augmentation, and application of this technology during the consultation process was correlated with a high degree of patient satisfaction and practice productivity.
authors: drc@creasman.com
authors: Craig N
authors: CN
authors: Creasman
authors: David
authors: D
authors: Mordaunt
authors: Tom
authors: T
authors: Liolios
authors: Catherine
authors: C
authors: Chiu
authors: Allen
authors: A
authors: Gabriel
authors: G Patrick
authors: GP
authors: Maxwell
mesh_terms: D000328:Adult; D019928:Breast Implantation / Q000379:methods*; D018427:Breast Implants; D003198:Computer Simulation; D003658:Decision Making, Computer-Assisted; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction