European Journal of Plastic Surgery (2018) 41:663–670

https://doi.org/10.1007/s00238-018-1431-2

ORIGINAL PAPER

New software and breast boundary landmarks to calculate breast

volumes from 3D surface images
T. S. Wesselius 1,2 & R. D. Vreeken 2 & A. C. Verhulst 1,2 & T. Xi 2,3 & T. J. J. Maal 2 & D. J. O. Ulrich 1

Received: 15 February 2018 / Accepted: 4 June 2018 / Published online: 6 July 2018
# The Author(s) 2018

Abstract
Background A method to accurately calculate breast volumes helps achieving a better breast surgery outcome. 3D surface
imaging potentially allows these calculations in a harmless, quick, and practicable way. The calculated volume from a 3D surface
image is dependent on the determined breast boundary and the method of chest wall simulation by software. Currently, there is no
consensus on a robust set of breast boundary landmarks and validation studies on breast volume calculation software are scarce.
The purposes of this study were to determine the robustness of newly introduced breast boundary landmarks and introduce and
validate a new method to simulate a chest wall.
Methods Sixteen subjects who underwent a unilateral simple mastectomy were included. In addition to the natural skin fold of
the breast, the sternomanubrial joint, the transition of the pectoral muscle curve into the breast curvature, and the midaxillary line
were used as landmarks to indicate the breast boundary. The intra- and interrater variability of these landmarks was tested.
Furthermore, new chest wall simulation software was validated on the breastless chest side of the subjects.
Results The intra- and interrater variability of the three breast boundary markers was small (mean 3.5–6.7 mm), and no signif-
icant difference was found between the intra- and interrater variability (p = 0.08, p = 0.06, and p = 0.10). The mean volume error
of the most accurately simulated chest wall was 4.6 ± 37 ml.
Conclusion The newly introduced landmarks showed to be robust and our new chest wall simulation algorithm showed
accurate results.
Level of Evidence: Level IV, diagnostic study.

Keywords 3D stereophotogrammetry . 3D surface imaging . 3D analysis . Breast volume . Breast landmarks

Introduction it is highly desired to have a method to accurately calculate

breast volumes preoperatively.
In order to achieve satisfactory results in breast surgery, Previously described methods to calculate the breast volume
such as breast reductions, augmentations, and reconstruc- such as water displacement [2–4], breast casts [5, 6], anthropo-
tions, a thorough understanding of the breast shape and morphic measurements [7], mammography [8], or MRI scans
breast volume is crucial. Many surgical decisions are based [9] are often tedious, costly, time consumptive, or yield widely
on a subjective estimation of the breast shape and volume varying results. The evolution of 3D imaging techniques in the
[1]. To improve the predictability of the postsurgical result, past decennium, 3D stereophotogrammetry in particular, pro-
vides a new approach of capturing 3D surface images. In 3D
stereophotogrammetry, multiple digital cameras are used to
* T. S. Wesselius
tycho.wesselius@radboudumc.nl capture an object under various angles and subsequently recon-
struct a 3D surface image. Since this technique is accurate,
1 harmless, quick, and increasingly available in clinics [10–12],
Department of Plastic-, Reconstructive-, and Hand Surgery, Radboud
University Medical Center, P.O. Box 9101, 6500, HB Nijmegen, the it is promising for routine breast volume calculations.
Netherlands Besides having a validated tool to perform the measure-
2
Radboudumc 3D Lab, Radboud University Medical Center, ment of breast volume, the two other most significant factors
Nijmegen, the Netherlands determining the outcome are the indicated breast boundary
3
Department of Oral and Maxillofacial Surgery, Radboud University and the simulated chest wall behind the 3D breast surface that
Medical Center, Nijmegen, the Netherlands enable the volume calculation.

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664 Eur J Plast Surg (2018) 41:663–670

Because breast boundaries determine the size and shape of simulate a chest wall is presented, along with a new validation
the simulated chest wall, the selected breast boundaries signif- method for chest wall algorithms. Our custom made 3D Breast
icantly influence the calculated breast volume from 3D sur- Analyzing Software Tool (3D BreAST) is based on these
face images. Therefore, it is important to accurately determine landmarks and the mentioned chest wall simulation algorithm.
the breast boundaries when breast volume calculations are
made from 3D surface image. Because of the natural skin fold
of the breast, the medial and inferior breast boundaries can
Materials and methods
easily be identified (Fig. 1). However, due to the lack of clear
anatomical landmarks, the superior-, superolateral-, and lateral
Subjects
breast boundaries leave room for ambiguous interpretations.
This has contributed to the inconsistent use of breast boundary
Sixteen female subjects who underwent a unilateral simple
landmarks in literature [10, 13–19].
mastectomy, i.e., removal of the breast tissue, nipple, and a
In addition to the landmarks that define the boundaries of a
small piece of overlying skin, and routine 3D surface imaging
breast, a dorsal cut-off plane that simulates the chest wall is
were included in this study (Table 1). Subjects with severe
required to make the breast volume measurement (Fig. 2).
chest wall deformations due to scarring were excluded.
Simulating such a surface within the breast boundaries can
Subjects with a high body mass index (BMI) have a substan-
be done with various software algorithms. Some studies used
tial amount of fat that deforms the chest wall. Therefore, sub-
a Coons patch algorithm [12, 20], some others developed their
jects with a BMI greater than 30 were excluded. The medical
own algorithm [21], while others used software tools without
ethical committee of the Radboud University Medical Center
mentioning the exact algorithm used [10, 14, 19, 22, 23].
approved this study and all subjects gave written informed
Because the algorithm for simulating a chest wall deter-
consent for the usage of their data. All data were anonymized
mines the calculated volume, validation and testing of the
and de-identified prior to analysis.
robustness of these algorithms are crucial. Chest wall algo-
rithms have been validated by comparing the calculated breast
volume with the resection weight [10, 12] or with the chest Landmark locations
wall from an MRI [14]. However, this does not actually val-
idate whether the simulated chest wall accurately describes the The axillary tail of the breast is orientated towards the
situation where skin, pectoral muscles, and rib cage are pres- midaxillary line. It is independent of the breast shape and
ent without breast tissue. In our opinion, the gold standard for can be located by using the middle of the armpit. The
validating a simulated chest wall should be an actual breastless superolateral breast boundary is defined by the transition of
female chest wall. the pectoral muscle curve into the breast curvature when the
This study introduces a set of landmarks for the identifica- subject spreaded her arms horizontally. The upper breast tissue
tion of lateral-, superolateral-, and superior breast boundaries boundary is located at the height of the second rib. The second
and is aimed at the evaluation of the intra- and interrater var- rib is attached to the sternomanubrial joint, which is very well
iability of these landmarks. Furthermore, a new algorithm to palpable by its bony edge. Therefore, the upper boundary of

Fig. 1 Breast boundaries. Note

that the superior- and
superolateral boundary are the
most difficult to define

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Eur J Plast Surg (2018) 41:663–670 665

observers. On every subject, observer 1 placed the set of land-

marks twice and observer 2 placed the landmarks once. Due to
slight difference in pose, two 3D surface images of a subject
are practically impossible to superimpose accurately. To de-
termine the intra- and interrater variability from a single 3D
surface image, all three landmark sets needed to be in place on
the subject. However, this introduced a possible bias for ob-
server 2 when he sees the landmarks placed by observer 1.
A solution to this problem was found by using glow in the
dark skin markers. The ink of glow in the dark skin markers is
only visible when it is illuminated with a blacklight (Fig. 3).
By using this ink for the first landmark set of observer 1 and
observer 2, the bias of knowing where other marker sets were
placed was dismissed. A green and blue markers were used for
Fig. 2 Example of a simulated chest wall behind the right breast. The the first two sets. The second landmark set of observer 1 was
breast was made transparent to make the simulated chest wall visible. The
simulated chest wall determines the closed volume of the breast and is directly marked with the 8-mm round stickers with a green
therefore essential for calculating breast volumes from a 3D surface color. Subsequently, the blacklight was used to detect the first
image landmark set of observer 1 and observer 2 to place orange and
blue stickers on them, respectively.
both breasts was defined to be at the level of the bony edge of
the sternomanubrial joint.
Acquiring 3D surface images

Placing multiple sets of breast boundary landmarks 3D surface images of the torso were acquired with a four-pod
stereophotogrammetry system consisting of 12 cameras
Five round stickers with a diameter of 8 mm were placed on the (3dMD™, Atlanta, USA). The subjects were instructed to
landmark locations described in the paragraph above. To prevent spread their arms horizontally and exhale normally.
movement of the superolateral landmark due to the skin mobility
in that area, the landmark was placed when the subject was in the Calculating landmark reproducibility
same pose as when the 3D surface image would be captured.
To determine the intra- and interrater distance variability of To obtain the intra- and interrater variability for each of the
the landmark placing, all landmarks were placed by two five landmarks, the Euclidean distances between the marker

Table 1 Characteristics of the

included subjects (n = 16) Subject # Age (years) BMI (kg/m2) Right breast history Left breast history

1 55 24.3 Mastectomy + RT –
2 46 28.0 Mastectomy –
3 57 26.3 Mastectomy –
4 65 19.8 Mastectomy + RT –
5 53 27.6 Mastectomy + RT –
6 40 25.4 Mastectomy + RT –
7 46 22.0 Mastectomy + RT –
8 39 21.3 Mastectomy –
9 49 23.2 Mastectomy –
10 56 20.8 Mastectomy –
11 48 24.3 – Mastectomy
12 62 23.4 – Mastectomy
13 46 23.2 – Mastectomy + RT
14 34 28.3 Mastectomy –
15 39 27.1 – Mastectomy
16 44 18.8 Mastectomy –

BMI body mass index, RT radio therapy

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666 Eur J Plast Surg (2018) 41:663–670

Fig. 3 Glow in the dark skin

markers. The ink of the markers is
invisible in daylight, but become
visible when illuminated with
blacklight. These markers were
used to enable the placement of
multiple landmark sets on the
subject without the observers
seeing previously placed sets

sets were calculated with the built-in measuring lint tool from by the direction of the surface superior to the upper boundary
Autodesk 3ds Max Studio 2016 (Autodesk Inc., CA, USA). spline vertices. The BCHL was a predetermined fraction of
Because the lateral boundary is independent from shifts the Euclidian distance between the end points of each vertical
in superior-inferior direction, only the ventral-dorsal di- Bézier curve. From the curve frame, a surface was created to
rection was taken into account when calculating the dis- simulate the chest wall (Fig. 5d).
tance between these landmarks. For similar reasons, only For each of the 16 subjects, three different chest walls
the superior-inferior direction was taken into account for were simulated by using BCHLs with a factor 0.20, 0.33,
the upper boundary. and 0.50 of the distance between the end points of the
Bézier curve (Fig. 4).
Algorithm to simulate the chest wall
Calculating the errors of the simulated chest walls
The algorithm to simulate a chest wall behind a breast was
written in Autodesk 3ds Max’s Maxscript. The algorithm cre- To determine the errors made by each of the 48 simulated
ates a surface that is based on a framework of Bézier curves chest walls, a distance map in respect to the true chest wall
that run from the upper breast boundary to the lower breast was created. To visualize the distances, each face was colored
boundary. The handle lengths of each vertical Bézier curve red or green depending on whether it was in front or behind
(BCHL) determine the curvature of the resulting surface: a the true chest wall, respectively (Fig. 5d). The intensity of the
longer handle results in a more convex surface (Fig. 4). color correlates with the size of the measured distance. To
The steps of creating the simulated chest wall are as fol- calculate the volume error made by each simulated chest wall,
lows. The 3D surface images were placed in a three-plane the surface size of each simulated chest wall was multiplied by
reference frame which is based on the five placed landmarks the mean relative distance to the true chest wall.
(Fig. 5a). By using fixed relative distances in respect to the
landmarks and the reference planes, eight breast boundary Statistical analyses
coordinates were selected on the 3D image (Fig. 5b).
Subsequently, a smoothed curve was fitted through the eight All landmarks were grouped into three groups: the
coordinates to indicate the breast boundary, and vertical sternomanubrial-, the superolateral breast-, and midaxillary
Bézier curves were created within the boundary (Fig. 5c). line landmarks. For each of the three groups, the means and
The direction of each Bézier curve handle was determined standard deviations of intra- and interrater Euclidean distances

Fig. 4 The effect of the Bézier curve handle length on the curvature of the The handle lengths are a fraction of the total length of the curve. a Bézier
simulated surface. The images a, b, and c show a right lateral view of a curve handle length = 0.20. b Bézier curve handle length = 0.33. c Bézier
female torso where the breast is cut off and a chest wall is simulated with curve handle length = 0.50. d Left lateral view of the right breast with all
three different Bézier curve handle lengths (yellow line with green knot). three surfaces in place, showing the differences between them

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Eur J Plast Surg (2018) 41:663–670 667

Fig. 5 Method of simulating a chest wall. a The 3D surface image is created from to the eight breast boundary points and is curved according
imported and manually placed in the reference frame consisting of a to the surrounding mesh curvature. Subsequently, the surface to simulate
sagittal, transverse, and frontal plane. The reference plane locations are the chest wall is created within the Bézier curve frame. d A distance map
based on the three breast boundary landmarks. b Eight breast boundary is created on the simulated chest wall surface. The intensity of the red
points (red dots) are placed on fixed locations according to the three breast color correlates with the distance to the true chest wall. The green part of
boundary landmarks and reference planes. c A Bézier curve framework is the surface is hidden behind the surface of the true chest wall

were calculated. A paired difference t test was used to deter- 6.7 mm). Furthermore, no statistically significant differ-
mine whether there was a difference between the intra- and ences were found between the intra- and interrater vari-
interrater landmark distances. abilities of the sternomanubrial-, superolateral-, and
For each of the three BCHL groups, the mean and standard midaxillary line markers (p = 0.08, p = 0.06, and p =
deviations were calculated for the distance to the true chest wall 0.10, respectively). However, a trend towards the
and its resulting volume error. One sample t tests were performed interrater variability being larger than the intrarater vari-
to determine whether the means were different from zero. ability seems to be present.
A p value smaller than 0.05 was considered to be statisti- In Table 3, the mean and standard deviation of the distances
cally significant. All statistical analyses were performed using between the simulated and true chest walls, the resulting vol-
SPSS version 22 (IBM Corporation, NY, USA). ume errors of the simulated chest walls, and the mean surface
area of the simulated chest walls are presented. The simulated
chest walls created by a BCHLs of 0.33 showed the best
Results approximation of a true chest wall (error of 4.6 ± 37 ml).
The volume errors of the BCHLs 0.20 and 0.33 did not differ
Table 2 shows that the absolute intra- and interrater vari- significantly from 0 (p = 0.21 and 0.63, respectively), while a
ability in marker placement was small (mean 3.5– BCHL of 0.50 did differ from 0 (p < 0.01).

Table 2 Intra- and interrater

variability of the three landmark Landmark location Intrarater distance Interrater distance p value*
locations in 16 subjects Mean ± SD (mm) Mean ± SD (mm)

Sternomanubrial joint (n = 16) 3.9 ± 2.6 5.8 ± 3.2 0.08

Superolateral breast (n = 32) 5.2 ± 2.5 6.7 ± 4.1 0.06
Midaxillary line (n = 32) 3.5 ± 2.2 4.6 ± 2.9 0.10

*p values were determined for the chances of the intra- and interrater distances being different

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668 Eur J Plast Surg (2018) 41:663–670

Table 3 Mean surface area, mean distance error, and the resulting volume error of the simulated chest walls created with the three Bézier curve handle
lengths (n = 16)

Bézier handle length Surface area of the simulated Distance error of the simulated Resulting volume error
chest wall Mean ± SD (cm2) chest wallMean ± SD (mm) Mean ± SD (ml)

0.20 283 ± 56 − 0.53 ± 1.4 (p = 0.15) − 13 ± 40 (p = 0.21)

0.33 283 ± 53 0.13 ± 1.3 (p = 0.69) 4.6 ± 37 (p = 0.63)
0.50 289 ± 56 1.2 ± 1.3 (p < 0.01) 37 ± 41 (p < 0.01)

p values were determined for the chances of the error being 0

Discussion the superior breast boundary near the clavicle or the ster-
nal notch introduces an undesirable large breast boundary,
Breast boundary landmarks because superiorly the breast tissue ends lower at the sec-
ond rib. In our experience, palpating the superior breast
The newly introduced breast boundary landmarks in this study boundary is mostly infeasible, especially when the patient
showed to be robust and can theoretically be used in patients is adipose. Lifting the breast to cause a wrinkle is an
with all body types. Furthermore, they can be used by multiple interesting method to define the upper boundary; howev-
software applications. The requirement for a software appli- er, in adipose subjects or subjects with small breasts, this
cation is that it either uses these specific landmarks to deter- is difficult to perform. Our proposed superior boundary
mine the breast boundary for a breast volume calculation or landmark at the sternomanubrial joint is very well palpa-
that it relies on a user-determined breast boundary without any ble in slim and adipose patient and does not introduce an
preprogrammed landmarks. This means that, in addition to our unnecessary large breast boundary, because the second rib
own 3D BreAST software, the landmarks can be used with is the anatomical upper limit of the breast.
3dMD Vultus software, which ships with every 3dMD camera Only Henseler et al. determined the intrarater variability for
setup that could be used to capture breasts. digitally placed breast boundary landmarks [18]. Because the
For the lateral breast boundary, most authors use the authors did not use a landmark for the superior and
lateral end of the inframammary fold [14–16, 19], while superolateral breast boundary, only their lateral breast bound-
some use the posterior axillary line [17] or palpate the ary landmark is comparable to our set. For this landmark, they
breast boundaries [10]. However, the lateral end of the reported an average intrarater distance of 4.5 ± 5.2 mm, which
inframammary fold is difficult to determine in adipose is larger than the 3.5 ± 2.2 mm we found for our lateral marker.
patients due to the fat roll that extends laterally from This puts our results in perspective and suggests that our
the breast to the back. The posterior axillary line can marker is more robust. No interrater variability or correlations
be determined in all patients, but it makes the breast between the marker set and the breast volume measurements
boundary unnecessary large since the breast does not were determined in their research.
reach to the back. In our experience, palpating the lateral
breast boundary in adipose patients is impossible. Our Chest wall simulation
lateral landmark on the mid-axillary line can be used in
adipose subjects, includes the axillary tail of the breast The three tested chest wall simulation types with Bézier curve
tissue, and shows no difference in intra- or interrater handle lengths of a factor 0.20, 0.33, and 0.50 of the distance
variability when placing it. between the end points of the curve yielded an average mean
The superolateral breast boundary in published studies is volume error of -13 ± 40, 4.6 ± 37, and 37 ± 41 ml, respective-
determined by the lateral offshoot of the pectoral muscle [14], ly. Together with our experience, the trend in these results
the common border of the upper arm and chest wall [17] or is suggests that the Bézier curve handle length of 0.33 is the best
arbitrarily chosen by the observer instead of being determined choice to use in our algorithm.
by anatomical landmarks [10, 19]. We chose the transition of To our knowledge, only Kovacs et al. [14] tried to deter-
the pectoral muscle into breast curvature as the superolateral mine the accuracy of their simulated chest wall to validate
boundary. This leaves room for interpretation, which explains their breast volume calculating software. They calculated the
the larger intra- and interrater variability. mean distance between 10 simulated chest walls from 3D
The superior breast boundary is often defined at the surface images to segmented chest walls from a corresponding
level of the clavicle [14–17], by the sternal notch height MRI scan. The mean error and standard deviation from their
[19], by palpation [10], or the location where the skin error measurements was 1.80 ± 3.77 mm. When using the
wrinkles when the subject lifts her breast [13]. Defining mean surface area of a simulated chest wall from our study

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Eur J Plast Surg (2018) 41:663–670 669

Fig. 6 User interface and steps to

use the 3D BreAST. a The user
interface. b The 3D photo is
placed in the reference frame and
the landmarks that indicate the
breast boundary are selected by
the user. c The simulated chest
wall that was created from the
selected breast boundary is shown
by making the breast surface
transparent. d The cut breast
which was capped at the back by
the simulated chest wall

(285 cm2), this would result in an average volume error of After placing stickers on the sternomanubrial-, superolateral
51.3 ± 107 ml. This is a factor 10 higher than a chest wall breast-, and midaxillary anatomical landmarks, capture a 3D
simulated with the most accurate parameter from our study. photo while the subject spreads her arms and exhales normal-
Furthermore, the approach introduces errors from the segmen- ly. (2) Open the 3D BreAST software (Fig. 6a) and import the
tation of the MRI scan and the alignment of the 3D surface 3D photo by clicking the BImport .obj^ button. (3) Create a
image with the MRI. It was not described how the chest wall reference frame by clicking the BCreate Frame^ button. (4)
deviation was calculated in their study. Position the 3D photo correctly and click BAccept
Two studies validated their algorithm with actual breast vol- Orientation^. (6) Click BCreate Cutter^ and select the breast
umes after resection, instead of a chest wall [10, 12]. Yip et al. boundary by clicking on the landmarks to simulate a chest
and Losken et al. reported a mean error of 46.7 ± 180 and - wall behind the breast surface (Fig. 6b). (7) Cut the breast
14.4 ± 61.8 ml, respectively. Both these means and standard from the 3D photo with the simulated chest wall by clicking
deviations are larger than the volume errors found in our study. BCut Breast^ (Fig 6c, d). (8) Click BCalculate Volume^ to print
Despite the exclusion of subjects with severe scars, defor- the breast volume on the screen.
mations of the chest walls were present in most subjects.
Furthermore, the contractions caused by the scarring some-
times caused sharp corners at the pectoral muscle, which the
simulated chest wall did not follow accurately. Therefore, the Conclusion
volume errors made by the simulated chest walls in this study
are probably slightly overestimated. This study shows that we have identified a robust set of breast
boundary landmarks and developed an accurate chest wall
simulation algorithm for breast volume calculations from 3D
Calculating a breast volume from a 3D photo surface images. These landmarks can potentially be used by
in clinical practice any software application that incorporates these landmarks to
define the breast boundary. This validation study is an impor-
To calculate a breast volume from a 3D photo with the 3D tant step in introducing our 3D BreAST software in clinical
BreAST software, one has to perform the following steps. (1) practice to routinely calculate breast volumes for surgical

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670 Eur J Plast Surg (2018) 41:663–670

planning. The next step is to compare the accuracy of our 8. Kalbhen CL, McGill JJ, Fendley PM, Corrigan KW, Angelats J
(1999) Mammographic determination of breast volume: comparing
method with existing methods.
different methods. Am J Roentgenol 173(6):1643–1649
9. Caruso MK, Guillot TS, Nguyen T, Greenway FL (2006) The cost
Compliance with ethical standards effectiveness of three different measures of breast volume.
Aesthetic Plast Surg 30(1):16–20
Funding No funding was received for this study. 10. Yip JM, Mouratova N, Jeffery RM, Veitch DE, Woodman RJ, Dean
NR (2012) Accurate assessment of breast volume. Ann Plast Surg
68(2):135–141
Conflict of interest T. S. Wesselius, R. D. Vreeken, A. C. Verhulst, T.
11. Mailey B, Freel A, Wong R, Pointer DT, Khoobehi K (2013)
Xi, T. J. J. Maal and D. J. O. Ulrich declare that they have no conflict of
Clinical accuracy and reproducibility of portrait 3D surgical
interest.
simulation platform in breast augmentation. Aesthet Surg J
33(1):84–92
Financial disclosure statement None of the authors have a financial 12. Losken A, Seify H, Denson DD, Paredes AA, Carlson GW (2005)
interest in any of the products, devices, or drugs mentioned in this man- Validating three-dimensional imaging of the breast. Ann Plast Surg
uscript. The 3D BreAST is software that was written by the corresponding 54(5):471–476
author as part of his PhD thesis at our 3D lab. We do not exploit the 13. Hoeffelin H, Jacquemin D, Defaweux V, Nizet JL (2014) A meth-
software financially or commercially nor do we intend to do this in the odological evaluation of volumetric measurement techniques in-
future. cluding three-dimensional imaging in breast surgery. Biomed Res
Int 2014(57324):1–10
Ethical approval All procedures performed in this study with human 14. Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M,
participants were in accordance with the ethical standards of the medical Schneider A, Udosic K, Schwenzer-Zimmerer K, Papadopulos
ethical committee of the Radboud University Medical Center (file 2017- NA, Biemer E (2006) New aspects of breast volume measure-
3494). ment using 3-dimensional surface imaging. Ann Plast Surg
57(6):602–610
Informed consent All subjects gave written informed consent for the 15. Eder M, Waldenfels FV, Swobodnik A, Klöppel M, Pape A-K,
usage of their data. Schuster T et al (2012) Objective breast symmetry evaluation using
3-D surface imaging. Breast 21(2):152–158
Open Access This article is distributed under the terms of the Creative 16. Eder M, Grabhorn A, Waldenfels FV, Schuster T, Papadopulos NA,
Commons Attribution 4.0 International License (http:// Machens H-G et al (2013) Prediction of breast resection weight in
creativecommons.org/licenses/by/4.0/), which permits unrestricted use, reduction Mammaplasty based on 3-dimensional surface imaging.
distribution, and reproduction in any medium, provided you give appro- Surg Innov 20(4):356–364
priate credit to the original author(s) and the source, provide a link to the 17. Liu C, Luan J, Ji K, Sun J (2012) Measuring volumetric change after
Creative Commons license, and indicate if changes were made. augmentation mammaplasty using a three-dimensional scanning tech-
nique: an innovative method. Aesthetic Plast Surg 36(5):1134–1139
18. Henseler H, Smith J, Bowman A, Khambay BS, Ju X, Ayoub A et
al (2012) Investigation into variation and errors of a three-
dimensional breast imaging system using multiple stereo cameras.
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