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c o m p u t e r m e t h o d s a n d p r o g r a m s i n b i o m e d i c i n e 9 0 ( 2 0 0 8 ) 95–103

journal homepage: www.intl.elsevierhealth.com/journals/cmpb

The stable status evaluation for female breast implant surgery by calculating related physics parameters Shuh-Ping Sun a,∗ , Ko-Wen Hsu a , Jing-Shyr Chen b a b

Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan Aesthetic Unit, Veterans General Hospital Kaohsiung, Taiwan

a r t i c l e

i n f o

a b s t r a c t

Article history:

Cosmetic doctor utilizes the position, size and shapes of female’s breast to judge whether

Received 15 January 2007

the breast is under steady-state condition after breast implant plastic surgery. Since, doctor

Received in revised form

evaluates the breast condition with the subjective discrimination (such as vision, sense of

10 July 2007

touch) without using the objective physical parameters auxiliary. This study uses the 3D

Accepted 18 November 2007

optics scanner editing 3D image to obtain full-scale 3D female breasts image. The CAD system converts the breast position, size and shapes, as the length of the curve between

Keywords:

UBL (upper breast line) and NBL (nipple base line), the length of the curve between NBL and

3D anthropometric measurement

LBL (lower breast line), breast volume and breasts congruence rate. The stability after the

Plastic surgery

breast implant plastic surgery is one of the important successful indexes of plastic surgery,

Reverse engineering

so with the continuity analysis the breast curve length, volume and congruence rate can let

Computer aided design

the doctor really grasp the stability of the breast after plastic surgery. © 2007 Elsevier Ireland Ltd. All rights reserved.

1.

Introduction

In recent years the relevant research on female’s breast parameters can be found in [1–6], most of the researcher defined the borderline (contour line) of female’s breast by congruence method and observed the breast area from several reference points. Then, software was used to calculate breast base line and breast volume. This research is to integrate 3D scanning technique and CAD system [7,8] then apply it to breast implant plastic surgery, parameterize the breast positions, sizes and shapes, making it possible for doctors and plastic surgery patients to make proper breast characteristics appraisal more quickly and rapidly. In order to make female find out about the state of one’s own breast shape, this research is to measure the relevant breast parameters scientifically. Integrating clinical and engineering experience, this study define female’s breast more accurately and more simply to make it clinically

convenient to get full size breast 3D images for analysis and appraisal. One of principle for this work is to get user friendly data and image of breast size, shape and position to lay out the post-surgery evaluation of breast implant surgery. It should be becomes a useful common consensus data between surgeons and patients.

2.

Background

A successful breast plastic surgery shall render the position, size and shape of the breast to the certain condition. Cosmetic surgeons judge female breasts according to the breast’s position, size and shape. As lack of common sense physical parameters defined as data, different understandings between surgeons and patients often arise. To avoid this misunderstanding, this work integrates and calculates the defined

∗ Corresponding author at: Department of Biomedical Engineering, I-Shou University, Kaohsiung, No. 1, Sec. 1, Syuecheng Road, Dashu Township, Kaohsiung County 840, Taiwan. Tel.: +886 7 6577711x6714; fax: +886 7 6577711 6701. E-mail address: spsun@isu.edu.tw (S.-P. Sun). 0169-2607/$ – see front matter © 2007 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.cmpb.2007.11.013


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Table 1 – The major equipment and facilities for full-scale 3D breast image capture and analysis system Equipment and Facilities

Application

3D Optics Scanner by 3D Digital Corp. Polyworks (3D point data editor) Geomagic Studio (3D image editor) Solid Works and Magics RP (3D solid model CAD system) Geomagic Qualify

Scan clinical 3D chest surface (measure 3D point cloud data). Coalition 3D point cloud data Breasts 3D image edition and establishment breast model. Calculate curve length and volume of 3D breast image Calculate congruence rate of breast shape

Fig. 1 – The standard measuring condition for female 3D breast image.

physical parameters with relevant software and hardware to ensure the reliability of stable status evaluation for breast surgery. The analyses of stable status of breast implant plastic surgery shall be made after breast plastic surgery. After the breast implant surgery, breast position, volume and congruence rate should be appraised and tracking. Through the analysis of the parameters, it should be ensured that doctors learn the post-surgery stability and set up patient’s clinic revisit bases.

3.

Design considerations

The hardware and software integrated by this study are mutual commercialize product. It makes the measurement and calculation of this work more reliable. The major equipment and facilities for full-scale 3D breast image capture and analysis system of this study can be shown in Table 1.

Fig. 2 – Female breast entity characteristic line and define area.


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Fig. 3 – The solid breast model area.

The standard measuring condition for female 3D breast image in this work is described as below. The subject assumes a “normal seating” posture on a standard measuring chair (Fig. 1), with the thighs closed up naturally, the hands freely put behind waist. With proper adjustment of the parts on the

3D laser scanner, the subject maintains a straight-up and consistent seating posture by forming right angle at the linkages of lens to the breasts, the position and angle can be shown on Fig. 1. As a rule, the majority of the burden of weight ought to be borne by the spine evenly. The full-scale 3D breast image

Fig. 4 – The upper breast curve length from UBL to NBL.


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Fig. 5 – The lower breast curve length from NBL to LBL.

can be coalition by 3D point data editor (Polyworks) and then integrated as a complete 3D breast image. This study base on the post-surgery analysis of female breast implants surgery (breast augmentation). The breast is

under well shaping condition. The characteristics edge points of breast 3D image are clear enough to figure out for define breast area (Fig. 2). Once obtained the full-scale 3D breast image. It needs to define several reference feature positions

Fig. 6 – The definition of breast volume.


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Fig. 7 – Calculation the breast volume.

on the body surface to analysis the breast 3D image [9–11] and acquire approximately physical parameters through the certain steps: (i) define breast feature area (the breast covers area between the second rib and the sixth rib) (as shown in Fig. 2) (ii) gain the breast position, size and shape accurately, this research applies the following three feature lines to define its area with human body real feature line as shown in Fig. 2. Positions of various feature lines are developing as follows:

(a) UBL (upper breast line)—breast highest feature line. It lies in the second rib connection line (straight line) in the mid of the anatomical thorax, approximately equals to the line connecting the mid points of two armpits. (b) NBL (nipple base line)—the second feature line defined in this study is the line connecting the nipples. (c) LBL (lower breast line)—breast lowest feature line. It approximately equals to the line connecting the lower edges of the breasts’ contacts with the body.

According to the feature line define in this study. The breast area can be picking out by using the midpoints of UBL, LBL and NBL then coordinate with edge points of UBL, LBL and NBL to create a rectangular breast area as the border lines (Fig. 2). Using 3D image editor the breast area can be seal by the curvature plane define in rectangular breast area. The breast area defines in this study then can be making as a solid breast model. The solid breast model made in this study is beginning from the chest wall, due to the curvature plane define in rectangular breast area (shown in Fig. 2) are perfectly close to the original 3D breast image (Fig. 3). The solid breast model defined in this study can match to the anatomical definition and can make breast volume sector define in this study more accuracy.

4.

System description

This study defines three border line names as UBL, NBL and LBL. Base on those border lines the length of the curve between


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45 62 74 80 85 (Fig. 8) 75.31 339.38 328.91 320.65 314.06 70.95 332.71 324.61 315.25 313.62 Presurgery 2 weeks post-surgery 2 months post-surgery 4 months post-surgery 6 months post-surgery

4.73 9.53 9.42 8.54 8.45

4.38 9.79 9.41 8.73 8.61

3.86 6.98 6.91 6.69 6.51

4.04 7.11 6.96 6.67 6.47

L.H.S. breast volume (cm3 ) R.H.S. breast volume (cm3 ) The curve length (cm) from NBL to LBL for L.H.S. breast The curve length (cm) from NBL to LBL for R.H.S. breast The curve length (cm) from UBL to NBL for L.H.S. (left hand side) breast The curve length (cm) from UBL to NBL for R.H.S. (right hand side) breast

Table 2 – Breast stability evaluation form of the case

Upgrade breast cup size from A to C+

Congruence rate (%)

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Fig. 8 – Calculation breast congruence matching rate.

UBL and NBL, the length of the curve between NBL and LBL, breast volume and breasts congruence rate can be define and measure. According to the border line the female’s breast condition appraisal can be carried out through three physical parameters: (I) the breast position is converted into the length of the curve linking UBL and NBL as well as the length of the curve linking NBL to LBL (II) the breast size is converted into the breast volume [12,13] (III) the breast shape is converted into the congruence rate of the breasts, judging the female’s breasts condition. Steps to get female’s breast condition appraisal physical parameters are described as follows in detail: (1) Acquire 3D full size image (a) Use 3D laser scanning to acquire original breast pixel data image files. (b) Utilize 3D image editor software (Geomagic Studio) to integrate the scanned files into a complete breast file (as shown in Fig. 2). (2) Calculate the length of the curve between UBL and NBL as well as the length of curve between NBL and LBL by using CAD software (Solid Works) (a) Use 3D image editor software to cut the line linking the midpoint of rib and the nipple. (b) Use CAD software to measure the lengths of the curves (from UBL to NBL, from NBL to LBL respectively) (as shown in Figs. 4 and 5). (3) Calculate breast volume (a) According to anatomical the position of female breast volume sector is between second rib to sixth rib and it beyond the chest wall. The distance between UBL and LBL define as the circular diameter of the breast volume sector. The breast volume sector defined in this study can match to the anatomical definition and can calculate breast volume precisely (Fig. 6). (b) Use 3D image editor (Geomagic Studio) and according to breast volume sector defined in this study (Fig. 6)


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Fig. 9 – Congruence matching rate between the left and right breast.

the individual breasts volume can be calculate by CAD software (Magics RP) as shown in Fig. 7. (c) Breast volumes were also computed using the formula published by Qiao et al. [14]: V = (1/3)MP2 × (MR+LR + IR − MP) to assure the breast volume measurement in this work is reliable. MR corresponds to the distance between the nipple and medial breast border, LR to the distance between the nipple and lateral breast border, IR to the distance between the nipple and inframammary fold, and MP to the mammary projection, which was measured by viewing the test participant from the lateral aspect from sternum to nipple. (4) Compare congruence rate (a) Use 3D image editor to get the left breast out for mirroring. (b) Use 3D image compiling software (Geomagic Qualify) to perform the congruence rate matching between the mirrored left breast file and the right breast file (as shown in Figs. 8 and 9).

5.

Status report

To ensure the evaluation of stable status precisely, this work integrate and calculate the above defined physical parameters with relevant software and hardware such as: the length of the curve between UBL and NBL, the length of the curve between NBL and LBL, breast volume and breasts congruence rate. As the breast position, size and shape have been parameterized, it is easier for doctors in appraisal the performing of surgery. Furthermore, the breast condition appraisal will be more objective. In this study, judge the breasts positions condition based on the difference between the lengths of curves between UBL and NBL as well as the difference between the lengths of curves and between NBL and LBL. It can judge the breast size condition by breasts volumes comparison. The breast shape condition can as well be judged by breasts congruence rate. Moreover, the author find out it can make a indirectly judge for any breast cup size whether the breast has achieved stability in the very first time by measuring the differences of the lengths of the curves between UBL and NBL as well as differences of the lengths of the curves between NBL and LBL a period after the surgery. In this work at least pick out 50 cases upgrade breast cup size from A to C+ for study. The characteristics of body build of

this work female are: the mean age, 25–45 years old; the mean height, 150–160 cm; the mean weight, 40–50 kg; the mean saline-filled breast implant, 240–270 cm3 . The tracking time interval present in this study is 24 weeks post-surgery and pick up data every 2 weeks. Each timing parameter’s collection can be classified a central tendencies, take mean value of defined parameters for each center tendency. Then the parameters can be plot with time to critique the stable status (Fig. 10). According to the static result (Fig. 10) when time approaches to 16–20 weeks will be beginning approach to the stable condition for breast plastic surgery. For augmentation mammaplasty with the formula introduced by Qiao [14], the breast volume for post-implant surgery can be calculated as follow: R.H.S. breast volume = 316.47 cm3 (MR = 8.83 cm, LR = 9.5 cm, IR = 6.51 cm, MP = 3.79 cm). L.H.S. breast volume = 325.62 cm3 (MR = 8.19 cm, LR = 10.08 cm, IR = 6.47 cm, MP = 3.86 cm). In this work 3D breast imaging was scanned then edited and calculated volumes using the algorism in Fig. 3 and Fig. 6. The breast volume measured as follow: R.H.S. breast volume = 313.62 cm3 ; L.H.S. breast volume = 314.06 cm3 . The anthropomorphic measurement breast volume by Qiao [14] were compared with measurement volume results of this work performed with the same patients in which the difference less than 5%. The method of volume measurement of this work is useful. To sum up above, one of extremely continuity breast surgery steady-state condition judgment cases by using three physical parameters is shown in Table 2.

6.

Lessons learned

Integrating human body 3D image compiling software and CAD data analysis system, this research calculates three physical parameters to appraise breast condition before and after surgery in addition to breast post-surgery stability. The three physical parameters are: the length of the curve between UBL and NBL, the length of the curve between NBL and LBL, breast volume and breasts congruence rate. Users can appraise the surgery accuracy with these three physical parameters. This system provides doctors with relevant physical parameters for breast appraisal to raise medical behavior accuracy. It can help plastic surgeons acquire substantial data, making their understandings of breast condition more objective as well as make doctors’ clinical management and figure appraisal more delicate. Tracking the post-surgery breast position (lengths of curves between UBL and NBL as well as between NBL and LBL), size (breast volume) and shape (breasts congruence rate), this


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Fig. 10 – The stable status evaluation for breast plastic surgery.


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research can help doctors understand the breast stability tendency after the surgery by data analysis of the parameters. The parameter of upper breast curve length, lower breast curve length, breast volume, and congruence rate are defined. In this study the size of breast are concentrate on cup size C+ (the most popular breast size for oriental female to upgrade). Each timing parameter’s collection can be classified a central tendencies then the parameters can be plot with time to critique the stable status (Fig. 10). During first 4 weeks of implant surgery the breast is under post-operative swelling condition. At the moment of breast decrease swelling, the breast volume and curve length between UBL, NBL, and LBL will decrease and approach to steady-state. Due to the swelling condition for each side breast is different then the congruence rate is decrease for first few weeks after surgery. Once breast decrease swelling the breast congruence rate will increase and approach to steady-state. This work finds out that, 6 months after the surgery (collect data every 2 weeks after surgery as shown in Fig. 10 and present one of typical case in Table 2) will under stable status, moreover the convergence-style stability for different breast cup size of breast position, size and shape can quick checked by such physical parameters as the lengths of curves between UBL and NBL as well as between NBL and LBL have achieved same quantity. It can provide doctors with relevant data requested for breast appraisal to raise the objectivity and consistency of the post-surgery breast stability. Hence, the clinical statistics of continuous revisits 6 months after the plastic surgery are useful indicator proposed for plastic doctors in this paper (Fig. 10).

7.

Future plans

This research has so far analyze more than 50 oriental cases (most of cases are upgrade the breast cup size from A to C+ ), appraising breast steady-state condition by three physical parameters (lengths of curves between UBL and NBL as well as between NBL and LBL, breast volume and breasts congruence rate). The data from Table 2 demonstrates that one of extremely case 6 months after breast implant surgery, physical parameters such as lengths of curves between UBL and NBL as well as between NBL and LBL, breast volume and breasts congruence rate achieve stability by convergence. This result can offer plastic surgeon important indicators in judging stability as well as raise the medical quality after surgery with medical resources saved. In the future the interface to calculate the physical parameters will be integrated into one package let it become more user friendly.

Conflict of interest None.

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references

[1] H.-Y. Lee, Ky. Hong, E.A. Kim, Measurement protocol of women’s nude breasts using a 3D scanning technique, Appl. Ergon. 35 (2004) 353–359. [2] O.M. Tepper, K. Small, L. Rudolph, M. Choi, N. Karp, Virtual 3-dimensional modeling as a valuable adjunct to aesthetic and reconstructive breast surgery, Am. J. Surg. 192 (2006) 548–551. [3] S. Garson, E. Delay, R. Sinna, T. Delaporte, M. Robbe, S. Carton, 3D evaluation and mammary augmentation surgery, Ann. chirurgie plastique esthetique 50 (2005) 643– 651. [4] C. Alfano, P. Mezzana, N. Scuderi, Acquisition and elaboration of superficial three-dimensional images in plastic and reconstructive surgery: applications, Indian J. Plast. Surg. 38 (2005) 22–26. [5] L. Kovacs, M. Eder, R. Hollweck, A. Zimmermann, M. Settles, A. Schneider, M. Endlich, A. Mueller, K. Schwenzer-Zimmerer, N.A. Papadopulos, E. Biemer, Comparison between breast volume measurement using 3D surface imaging and classical techniques, Breast 60 (2007) 137–145. [6] S. Garson, E. Delay, R. Sinna, S. Carton, T. Delaporte, K. Chekaroua, 3D evaluation and breast plastic surgery: preliminary study, Ann. chirurgie plastique esthetique 50 (2005) 296–308. [7] S.-P. Sun, J.-S. Chen, The application of full-scale 3D anthropometric digital model system on breast reconstruction of plastic surgeries, Biomed. Eng. Appl. Basis Commun. 15 (2003) 200–206. [8] S.-P. Sun, H.-H. Chen, L.-C. Lin, G. Cheng-Chie Niu, Y.-F. Chen, The Integration of 3-D Hip-Shape Anthropometric Data Bank and human-engineered seat-cushion: the classification of hip shapes and category of seat cushions, Biomed. Eng. Appl. Basis Commun. 15 (2003) 77– 81. [9] Seung-Woo Kim, Yi-Bae Choi, Jung-Taek Oh, Reverse engineering: high speed digitization of free-form surfaces by phase-shifting grating projection moire topography, Int. J. Machine Tools Manuf. 39 (1999) 389–401. [10] J.W. Kim, S.Y. Lee, K.H. Hong, Development of sensible brassiere for middle aged women, J. Korean Soc. Clothing Textiles 24 (5) (2000) 714–723. [11] K.H. Lee, A study on analysis of breast shapes by replica experiments, J. Korean Soc. Clothing Textiles 21 (4) (1997) 689–698. [12] C.W. Loughry, D.B. Sheffer, T.E. Price Jr., M.J. Lackney, R.G. Bartfai, W.M. Morek, Breast volume measurement of 248 women using biostereometric analysis, Plast. Reconstr. Surg. 80 (4) (1987) 553–558. [13] D.J. Smith Jr., W.E. Palin Jr., V.L. Katch, J.E. Bennett, Breast volume and anthropomorphic measurements: normal values, Plast. Reconstr. Surg. 78 (3) (1986) 331–335. [14] Qun Qiao, Gang Zhou, Yi-chun Ling, Breast volume measurement in young chinese women and clinical applications, Aesth. Plast. Surg. 21 (1997) 362–368.

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