ORIGINAL ARTICLE Three-Dimensional Laser Imaging as a Valuable Tool for Specifying Changes in Breast Shape After Augmentation Mammaplasty Danielle L. Esme Æ Alexander Bucksch Æ Werner H. Beekman Received: 9 May 2008 / Accepted: 23 September 2008 / Published online: 4 November 2008 Ó Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2008 Abstract Background Three-dimensional (3D) terrestrial laser scanning (TLS) is a valuable method for measuring shapes of objects and for obtaining quantitative measurements. These qualities of the 3D laser scanner have proved to be useful in reconstructive breast surgery. This study investi- gated various 3D parameters to obtain an optimal objective visualization of the breast after cosmetic augmentation mammaplasty. Methods The objects are represented in a point cloud, which comprises millions of x, y, and z coordinates rep- resenting a virtual image. The quantification of 3D points shows changes in height (z coordinate) at any chosen point on the augmented breast (x and y coordinates). To give visual feedback on the change in dimensions, a color ele- vation scheme was applied on the reconstructed surface of the breast. As a quantifying description, a sagittal B-spline was chosen in a plane through the nipple to obtain the breast shape via the lateral profile. Results Pre- and postoperative clear images were obtained. The color elevation model showed an increased projection and upper pole fullness after augmentation. The B-spline showed the gain in projection in a sagittal plane through the nipple. Conclusions Three-dimensional TLS is capable of objectifying changes in shape after augmentation mam- maplasty. This imaging technique represents superior visualization of the breast shape and can serve as a valuable tool to determine the changing dimensions of the breasts after augmentation mammaplasty. Keywords 3D Terrestrial laser scanning Á Augmentation mammaplasty In recent years, terrestrial laser scanning (TLS) has become a standard tool in three-dimensional (3D) shape measuring for a wide variety of objects including construction works, industrial plants, forestry, and buildings [1, 3, 10, 23]. With TLS, it is possible to measure millions of 3D points in a few seconds and to create highly detailed and accurate computer models of a shape. It is a rapidly developing application for obtaining the shape, contour, size, and volume of objects. The medical field also may benefit from advances in 3D imaging [5, 8, 12, 21]. In plastic surgery, 3D modeling offers unique opportunities in reconstructive breast surgery [9], providing visual and quantitative assessment of reconstructed breasts [9, 11]. Until recently, no techniques were available to objectify the change in the breasts after cosmetic breast implant surgery. In our study, we performed intraoperative 3D laser imaging before and directly after implantation to assess the contour, shape, and volume changes of the breast after implantation of silicone gel-filled breast prostheses. D. L. Esme (&) Á W. H. Beekman Department of Plastic and Reconstructive Surgery, Tergooiziekenhuizen Hilversum, Van Riebeeckweg 212, 1213 XZ Hilversum, The Netherlands e-mail: danielle@sandan.nl A. Bucksch Faculty of Aerospace Engineering, Delft Institute of Earth Observation and Space Systems (DEOS), Delft University of Technology, Delft, The Netherlands 123 Aesth Plast Surg (2009) 33:191–195 DOI 10.1007/s00266-008-9259-y