3D Breast Scanning in Plastic Surgery Utilizing Free iPhone LiDAR Application: Evaluation, Potential, and Limitations.

Background: Three-dimensional (3D) imaging enhances surgical planning and documentation in plastic surgery, but high costs limit accessibility. Mobile Light Detection and Ranging (LiDAR) technology offers a potential cost-effective alternative.

Objectives: To evaluate the accuracy and clinical utility of iPhone-based LiDAR scanning for breast measurements compared to traditional methods, and to establish standardized protocols for clinical implementation.

Methods: In this prospective validation study, 25 consecutive patients (mean age: 44 years; range: 32-64 years; mean BMI: 23.2 kg/m²) undergoing breast procedures were evaluated using the "3D Scanner App" on iPhone 15 Pro (Apple Inc., Cupertino, CA). Three standardized measurements (sternal notch-to-nipple, nipple-to-midline, nipple-to-inframammary fold) were compared between LiDAR and manual techniques. Technical error of measurement (TEM) and relative TEM (rTEM) were calculated. Inter-rater reliability, learning curve assessment, and cost-effectiveness analysis were performed.

Results: LiDAR measurements showed very good accuracy for sternal notch-to-nipple (rTEM 1.43%, 95% CI: 1.21-1.65) and nipple-to-midline distances (rTEM 3.45%, 95% CI: 3.12-3.78). Nipple-to-inframammary fold measurements showed moderate accuracy (rTEM 8.80%, 95% CI: 8.21-9.39). Inter-rater reliability was excellent (ICC=0.92). Learning curve analysis demonstrated measurement stability after 5 cases. Cost analysis revealed 97.8% reduction in initial investment compared to commercial 3D imaging systems.

Conclusions: Mobile LiDAR technology provides accurate breast measurements for most anatomical landmarks at a fraction of the cost of traditional 3D imaging systems. The technology shows excellent reliability after a short learning curve, offering an accessible solution for surgical planning and documentation.