Mammometrics: the standardization of aesthetic and reconstructive breast surgery.

The goal of cosmetic and reconstructive breast surgery is to create symmetric and aesthetically pleasing results in a reproducible manner. Although continued progress is dependent on the ability of plastic surgeons to accurately assess surgical outcomes, available methods to objectively evaluate aesthetic and reconstructive breast surgery are limited. This is quite different from other areas of plastic surgery, such as craniomaxillofacial surgery, that often use precise skeletal measurements to provide a platform for preoperative and postoperative analysis. In comparison, systematic evaluation of breast surgery has yet to be standardized. With the advent of three-dimensional photography, objective soft-tissue analysis of the breast is now possible. Recent work from our group and others has validated the use of three-dimensional breast photography in various clinical arenas, including autologous breast reconstruction, prosthetic breast reconstruction, reduction mammaplasty, and augmentation mammaplasty.1–7 Enthusiasm toward three-dimensional imaging technology has stemmed from the ability to not only obtain well-established breast measurements in an accurate manner, but also to generate measurements that were not previously possible with conventional tools, such as total breast volume, volumetric distribution, and breast projection. This article provides an overview of three-dimensional breast photography, with particular emphasis on its potential role to establish a standardized system for breast analysis. We introduce a new concept termed “mammometrics,” in which three-dimensional–based breast measurements can be used to help guide operative planning, objectively analyze surgical results, and document postoperative changes that occur over time.