The evolution of photography and three-dimensional imaging in plastic surgery

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Article

Reference

The evolution of photography and three-dimensional imaging in plastic surgery

ORANGES, Carlo M, et al.

Abstract

We read with extreme interest the article by Weissler et al, entitled “The Evolution of Photography and Three-Dimensional Imaging in Plastic Surgery” published in the March of 2017 issue of the Journal.1 We congratulate the authors for this ambitious undertaking, which presents a historical review of the fascinating progress made in photography in plastic surgery and highlights the clinical utility of three-dimensional imaging in our practice. As observed in the article, this technology appears to be the most appropriate to provide an objective evaluation of outcomes, especially when a volume change is included as a primary goal of the operation. The implications for procedures such as fat grafting are certainly remarkable, as a volumetric and morphologic analysis demonstrating true surface dimensions both preoperatively and postoperatively becomes available. Among the many, one of those implications refers to clinical studies reporting or comparing fat graft survival achieved using different techniques, which in the future will require documentation with objective measures of the recipient-site volume at the baseline [...]

ORANGES, Carlo M, et al . The evolution of photography and three-dimensional imaging in plastic surgery. Plastic and Reconstructive Surgery , 2018, vol. 141, no. 1, p. 196e-197e

DOI : 10.1097/PRS.0000000000004005 PMID : 28938370

Available at:

http://archive-ouverte.unige.ch/unige:155251

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Plastic and Reconstructive Surgery • January 2018

Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.

5. Haase SC. Systematic reviews and meta-analysis. Plast Reconstr Surg. 2011;127:955–966.

6. Chung KC. JHS guidelines on systematic review and meta- analysis submissions. J Hand Surg Am. 2012;37:1121–1124.

results may still be considered useful with caution. In addition, the individual studies each found no differ- ence in bleeding incidence between ibuprofen and control, which is concordant with our findings.

Their fourth point concerns use of the Jadad scale, which we included in addition to other forms of bias analysis. Although the authors are correct to note that this is not the most up-to-date system for bias analysis, it was included as an adjunct for com- pleteness. We also performed a Grading of Recom- mendations Assessment, Development and Evaluation analysis. The Grading of Recommendations Assess- ment, Development and Evaluation guidelines, with which the authors do not seem to be familiar, is a process for rating the quality of scientific evidence. Figure 2 is a graphic representation using the RevMan software suite from the Cochrane Collaboration.⁴ Grad- ing of Recommendations Assessment, Development and Evaluation analysis is a component of the software package. Further discussion of the use of the Grading of Recommendations Assessment, Development and Evaluation guidelines can be reviewed in the plastic surgery literature.^5,6

DOI: 10.1097/PRS.0000000000004004

Brian P. Kelley, M.D.

Jeffrey H. Kozlow, M.D., M.S.

Section of Plastic and Reconstructive Surgery University of Michigan Health System Ann Arbor, Mich.

Correspondence to Dr. Kozlow Section of Plastic Surgery University of Michigan Health System 2130 Taubman Center 1500 East Medical Center Drive Ann Arbor, Mich. 48109-0340 [email protected] This manuscript and the research described complied with the Declaration of Helsinki.

DISCLOSURE

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this communication.

REFERENCES

1. Schjerning Olsen AM, Gislason GH, McGettigan P, et al.

Association of NSAID use with risk of bleeding and cardio- vascular events in patients receiving antithrombotic therapy after myocardial infarction. JAMA 2015;313:805–814.

2. Gobble RM, Hoang HL, Kachniarz B, Orgill DP. Ketoro- lac does not increase perioperative bleeding: A meta-anal- ysis of randomized controlled trials. Plast Reconstr Surg.

2014;133:741–755.

3. Kelley BP, Bennett KG, Chung KC, Kozlow JH. Ibuprofen may not increase bleeding risk in plastic surgery: A systematic review and meta-analysis. Plast Reconstr Surg. 2016;137:1309–

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4. Higgins JP, Altman DG, Gøtzsche PC, et al.; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The

The Evolution of Photography and Three- Dimensional Imaging in Plastic Surgery

Sir:

W

e read with extreme interest the article by Weissler et al, entitled “The Evolution of Photography and Three-Dimensional Imaging in Plastic Surgery” pub- lished in the March of 2017 issue of the Journal.¹ We congratulate the authors for this ambitious undertaking, which presents a historical review of the fascinating progress made in photography in plastic surgery and highlights the clinical utility of three-dimensional imaging in our practice. As observed in the article, this technology appears to be the most appropriate to provide an objective evaluation of outcomes, especially when a volume change is included as a primary goal of the operation. The implications for procedures such as fat grafting are certainly remarkable, as a volumetric and morphologic analysis demonstrating true surface dimensions both preoperatively and postoperatively becomes available. Among the many, one of those implications refers to clinical studies reporting or comparing fat graft survival achieved using different techniques, which in the future will require documentation with objective measures of the recipient-site volume at the baseline and at postoperative follow-up visits.

In this regard, we recently introduced in our practice an extremely inexpensive and easily handled device and a three-dimensional imaging elaboration process that were not mentioned in the article by Weissler and colleagues.

We perform our scanning process through an instrument connected to an iPad Pro (Apple, Inc., Cupertino, Calif.) called Structure Sensor 3D scanner (Occipital, Inc., Boulder, Colo.), a structured/infrared light hand- held scanner that measures 11.92 (width) × 2.9 (height)

× 2.8 (depth) cm and has a weight of 95 g, available at a price of $379 (Fig. 1). We regularly use the device to assess volume change in the fat graft recipient site when a moderate volume of fat is transplanted to treat breast surgery sequelae, such as contracted scar, and a precise evaluation is needed for adequate outcome estimation.^2–4 Three-dimensional images are then elaborated using a three-dimensional mesh-processing application called MeshLab 2016, which is available as open-source software, to clean the three-dimensional raw data and calculate body volumes. Calculations for the breast are performed according to mammometrics landmarks described in this Journal by Tepper et al.⁵ in 2010 (Fig. 2).

We believe that our approach could easily become part of the everyday plastic surgery practice, not just in the academic setting but even in private, because of the very limited dimensions and cost of the instrument and its simple handling, especially compared with other

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Volume 141, Number 1 • Letters

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options listed by Weissler et al.¹ However, our procedure only allows volume calculations and therefore evaluation of baseline conditions and acquired outcomes, and not simulation of predicted outcomes, to be shown preoperatively to the patient, which is instead possible with a similar but more expensive technology such as Crisalix (Crisalix Virtual Aesthetics, Bern, Switzerland). In conclu- sion, as for many other innovations throughout history, we observe that the role of plastic surgery among medical specialties is at the forefront in implementing this hot topic technology, which belongs to the field of aug- mented reality and aims at providing a computer-medi- ated reality, where physical elements of the real world are supplemented by computer-generated sensory inputs.

DOI: 10.1097/PRS.0000000000004005

Carlo M. Oranges, M.D.

Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery

Florian M. Thieringer, M.D., D.D.S., M.H.B.A.

Department of Oral and Cranio-Maxillofacial Surgery Daniel F. Kalbermatten, M.D., Ph.D.

Martin Haug, M.D.

Dirk J. Schaefer, M.D.

Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery

Basel University Hospital Basel, Switzerland Correspondence to Dr. Oranges Department of Plastic, Reconstructive,

Aesthetic, and Hand Surgery Basel University Hospital Spitalstrasse 21 4031 Basel, Switzerland [email protected] The first two authors contributed equally to this work.

DISCLOSURE

None of the authors has a financial interest in any of the products or devices mentioned in this communication. There was no funding for this work.

REFERENCES

1. Weissler JM, Stern CS, Schreiber JE, Amirlak B, Tepper OM. The evolution of photography and three-dimen- sional imaging in plastic surgery. Plast Reconstr Surg.

2017;139:761–769.

2. Oranges CM, Schaefer DJ. The use of autologous fat grafting for treatment of scar tissue and scar-related condi- tions: A systematic review. Plast Reconstr Surg. 2016;138:

551e–552e.

3. Oranges CM, Schaefer DJ. Induction of adipogenesis by external volume expansion. Plast Reconstr Surg. 2016;138:

769e–770e.

4. Oranges CM, Tremp M, Ling B, Wettstein R, Largo RD, Schaefer DJ. A simple, reliable, and inexpensive intra- operative external expansion system for enhanced autol- ogous structural fat grafting. Arch Plast Surg. 2016;43:

466–469.

5. Tepper OM, Unger JG, Small KH, et al. Mammometrics: The standardization of aesthetic and reconstructive breast sur- gery. Plast Reconstr Surg. 2010;125:393–400.

Fig. 1. The Structure Sensor 3D scanner, connected to an iPad Pro.

Fig. 2. Three-dimensional image of the breast captured with the Structure Sensor 3D scanner and elaborated using the three- dimensional mesh-processing application MeshLab 2016. Breast volume is calculated according to mammometrics landmarks as described by Tepper et al. (Tepper OM, Unger JG, Small KH, et al. Mammometrics: The standardization of aesthetic and reconstructive breast surgery. Plast Reconstr Surg. 2010;125:393–400.)

Reply: The Evolution of Photography and Three- Dimensional Imaging in Plastic Surgery

Sir:We thank the authors for their comments regard- ing our recent publication in Plastic and Reconstructive Surgery entitled “The Evolution of Photography and Three-Dimensional Imaging in Plastic Surgery.”¹ We are excited to learn how they are using this technology to make volumetric measurements of the breast.

First and foremost, we commend the application of three-dimensional imaging technology to improve clinical practice. For years, three-dimensional imaging has primarily been used for patient consultations, as