# Symmetry After Breast Reconstruction Surgery: A Comparison of Immediate vs. Delayed-Immediate Breast Reconstruction Using Smartphone-Based 3D Surface Imaging

## TL;DR

This study compares breast symmetry outcomes after immediate and delayed-immediate breast reconstruction using smartphone-based 3D imaging, finding no significant differences between the two methods.

## Contribution

The novel use of smartphone-based 3D imaging to assess breast symmetry in immediate versus delayed-immediate reconstruction is introduced.

## Key findings

- No significant differences in 11 of 14 measurements between immediate and delayed-immediate BRS.
- Symmetry index (SI) was not significantly different between immediate (M = 0.85) and delayed-immediate (M = 0.88) BRS.
- Patient characteristics like age, BMI, and flap weight showed no significant differences between the two groups.

## Abstract

Background: Breast reconstruction surgery (BRS) is a vital coping mechanism for patients undergoing mastectomy. Various methods have been introduced, including immediate and delayed-immediate BRS. This study employs a smartphone-based approach for three-dimensional (3D) surface imaging to compare outcomes after immediate vs. delayed-immediate BRS. Methods: Twenty-six patients who underwent BRS using the deep inferior epigastric perforator (DIEP) flap at our institution from 1 October 2018 to 1 October 2023 were included in this study. Thirteen patients underwent immediate BRS and thirteen underwent delayed-immediate BRS. Following successful BRS, each patient underwent a digital anthropometric examination that included 14 measurements and the calculation of the symmetry index (SI) using the iPhone 15 Pro along with the 3D Scanner App and the Vectra Analysis Module (VAM). Measurements were subsequently compared between immediate and delayed-immediate BRS using the t-test for independent samples. Results: For 11 of 14 measurements, no significant differences were detected between immediate and delayed-immediate BRS. The SI did not differ significantly between immediate (M = 0.85) and delayed-immediate (M = 0.88) BRS (t-test for independent samples; p = 0.23, n = 26, two-tailed). Additionally, no significant differences were found between patients’ age, height, weight, BMI, time since first diagnosis, and flap weight using a t-test for independent samples. Conclusions: No statistically significant differences in breast symmetry were detected between immediate and delayed-immediate reconstruction in this cohort. This study supports the integration of smartphone-based 3D imaging into routine plastic surgery.