Computer-Assisted Analysis of Images for Evaluation of Long-Term Reduction Mammaplasty Results

Abstract

To the Editor, Measurement methods that can evaluate breasts after reduction mammaplasty enable evaluation of changes in the breasts over time. Many researchers have focused on direct methods for measuring breast volume and size such as topography, anthropometric measurements, mammography, magnetic resonance imaging, biometric evaluations, stereophotographic techniques, the water displacement method, and measurements using special devices [1–5]. Most of these methods are time-consuming, cumbersome, and impractical for use in clinical settings. Furthermore, these techniques are not easily available, feasible, or cost effective. Moreover, some of the methods require complicated formulas for analyses. Plastic surgeons routinely use photographs to evaluate and record the preand postoperative appearance of patients. We developed a computer-assisted analysis of photographic images that can be used to evaluate shortand long-term changes after reduction mammaplasty using Adobe Photoshop CS software (Adobe systems Inc., San Jose, CA, USA). This study aimed to evaluate and compare the long-term results after reduction mammaplasty. Bottoming-out deformity, nipple transposition distance, and other distortions can be analyzed objectively using the method of analysis we developed. The method also enables selfevaluation by the surgeon, which can be used to increase knowledge about reduction mammaplasty procedures. Ewart et al. [6] reported using Adobe Photoshop software to plan surgery for two rhinoplasty patients. Karsidag et al. [7] used this software to evaluate the results of reduction mammaplasty by combining half-views of preand postoperative images in the same frame for comparison. Kreithen et al. [8] used a PowerPoint presentation for photographic comparisons of different reduction techniques. The preoperative measurements included the midclavicle-to-nipple distance, the sternal notch-to-nipple distance, the inframammary fold-to-nipple distance, the diameter of the nipple–areola complex (NAC), the width of the pedicle, and the planned postoperative NAC position. Standard anterior, lateral, and oblique digital photographs were taken with the patient in the standing position using a Nikon D100 (Nikon Inc., Melville, NY, USA) digital camera at a distance of 1.5 m. All photos were taken using a standardized position and distance with the same camera. The settings of the camera such as zoom, light, pixels, and the like were the same while the photos were taken. The same sets of photographs also were taken during the early postoperative period (B6 months) and the late postoperative period ([2 years). All measurements were routinely recorded in a database program. C. Firat Department of Plastic Surgery, Inonu University School of Medicine, Malatya, Turkey