Cartography and Topographic Mapping: The Historical Basis for the Standardization of Anatomical Analysis and Surgical Mark-Making to Improve Outcomes in Body Contouring.

Abstract

Maps have been used for thousands of years to guide and advance mankind's interests. Recently, cartography has grown exponentially into standardized, densely layered systems, facilitating countless functions that use complex algorithms and multifactorial data. Surgeons have successfully addressed bodily concerns for centuries, aided by consistency of human anatomy, physiologic responses to disease, and patterns of disease. However, body contouring techniques alter the much more inconsistent surface anatomy of stretched or aged skin and highly variable subcutaneous fullness. To date, no consistent strategy has been proposed to analyze, map, and alter human shape in a standardized fashion; however, well-established cartographic methods for topographic mapping can be logically adapted to meet surgical needs. Quantification of results, valid and meaningful comparison of techniques, and anatomical discovery could all be achieved by adopting cartographic methods. As anatomists and scientists, surgeons constantly seek logical and reproducible methods to improve patient outcomes. In this article, the authors present a technique derived from topographic mapping, applied directly to the surface of the human body, reflecting the actual underlying anatomy, to guide both elective and reconstructive procedures. The method provides logical and quantifiable methods for (1) the analysis of anatomy, (2) data-driven planning of surgical care, and (3) a consistent operative implementation-so that each patient can receive individualized, anatomically based procedures. Use of well-established mapping strategies would also promote interdisciplinary collaboration, permit adaptation of software to analyze volume and shape, and improve patient outcomes through quantification of change and meaningful comparisons of procedural options.