Expanding Access to 3D Technology in Plastic Surgery of the Breast: Validation of the iPhone Against the Vectra H2.

Background: The iPhone contains a high-fidelity 3-dimensional (3D) scanner and is widely distributed in the United States. Presently, 3D analysis of the breast necessitates ownership of cost-prohibitive cameras and software packages such as the Vectra (Canfield Scientific Inc., Parsippany, NJ) system.

Objectives: We compared the accuracy of 3D photographs of the breast obtained with the iPhone X 3D scanner (Apple Inc., Cupertino, CA) with the Canfield Vectra H2 in an effort to expand access to 3D technology in plastic surgery.

Methods: Twenty breasts (n = 20) were 3D photographed with the iPhone X and the Vectra H2 and compared by colormap analysis and by measuring distances across the models between key anatomical landmarks. These distances included sternal notch to nipple (SN-N), midchest to nipple (M-N), nipple to midinframammary fold (N-IMF), and inframammary fold width (IMF). Statistical tests included the Bland-Altman plot analysis.

Results: When comparing absolute differences in distances between key anatomical landmarks, the average discrepancy in measurements between the iPhone and Vectra image pairs were the following: SN-N: 0.94 mm, M-N: 0.81 mm, N-IMF 0.91 mm, and IMF 0.98 mm. Colormap analysis demonstrated an average error of 1.53 mm, mean of 0.53 mm, and standard deviation of ±1.81 mm. Bland-Altman plot revealed a mean difference of 0.13 mm and an agreement interval between -1.90 and 2.17 mm.

Conclusions: The iPhone is capable of capturing 3D photographs with a high level of fidelity when compared with the Vectra. Three-dimensional scans obtained with the iPhone may be helpful for planning nipple position, measuring the breast footprint, choosing implants, and performing other functions with 3D technology that are typically performed with the more expensive systems.

Level of evidence: 5: