Current Concepts and Emerging Technologies in Aesthetic Outcome Assessment of Breast Reconstruction.

Deyu Lyu; Felix H Vollbach; Irene Mesas Aranda; Benedikt Fuchs; Sinan Mert; Constanze Kuhlmann; Christine S Hagen; Riccardo E Giunta; Nikolaus Thierfelder; Nicholas Moellhoff

doi:10.1093/asj/sjag101

PubMed · 42159042

Current Concepts and Emerging Technologies in Aesthetic Outcome Assessment of Breast Reconstruction.

Deyu Lyu·Felix H Vollbach·Irene Mesas Aranda·Benedikt Fuchs·Sinan Mert·Constanze Kuhlmann·Christine S Hagen·Riccardo E Giunta·Nikolaus Thierfelder·Nicholas Moellhoff

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Abstract

Aesthetic outcomes are a crucial determinant of the overall success of breast reconstruction. Recently, aesthetic assessment has evolved from relying mainly on subjective impressions to incorporating more quantitative methods. This systematic review summarizes current concepts and emerging technologies in aesthetic outcome assessment after breast reconstruction. A comprehensive search of studies evaluating aesthetic outcomes following implant-based, autologous or hybrid breast reconstruction was performed between 2000 and 2025. Assessments were classified as subjective or objective. Extracted variables included assessment characteristics, aesthetic outcome domains, and patient-centered outcomes. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Levels of evidence were classified according to the Oxford Centre for Evidence-Based Medicine. A total of 51 studies involving 7711 participants from 16 countries were included. Subjective tools were most frequently employed, led by the BREAST-Q (35/51, 69%), followed by expert- or panel-based evaluations (17/51, 33%) and the visual analog scale (2/51, 4%). Objective methods were applied in 19 studies and included 3-dimensional surface imaging (8/51, 16%), BCCT.core (7/51, 14%), eye tracking (3/51, 6%), and artificial intelligence-based analyses (3/51, 6%). Although subjective tools captured satisfaction with breast appearance, objective tools quantified morphological parameters and positional landmarks. BREAST-Q remains the cornerstone of outcome evaluation after breast reconstruction, providing patient-centered perspectives, including, but not limited to, aesthetic perception. A progressive shift toward multimodal evaluation was noticed, as no single modality comprehensively addressed all aesthetic domains. Future research should focus on integrating subjective and objective assessment methods within a unified framework. Level of Evidence: 3 (Therapeutic) For image description, please refer to the figure legend and surrounding text.

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Humans Female Esthetics Mammaplasty Patient Satisfaction Treatment Outcome Outcome Assessment, Health Care Imaging, Three-Dimensional Breast Implants Breast Neoplasms Journal Article Systematic Review

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Deyu Lyu, Felix H Vollbach, Irene Mesas Aranda, Benedikt Fuchs, Sinan Mert, Constanze Kuhlmann, Christine S Hagen, Riccardo E Giunta, Nikolaus Thierfelder, Nicholas Moellhoff. 2026-09-16. Current Concepts and Emerging Technologies in Aesthetic Outcome Assessment of Breast Reconstruction.. https://doi.org/10.1093/asj%2Fsjag101

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Journal Article; Systematic Review resource Breast Neoplasms subject Female subject Humans subject Imaging, Three-Dimensional subject Journal Article subject Mammaplasty subject Outcome Assessment, Health Care subject Patient Satisfaction subject Systematic reviews study

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