%0 Journal Article
%T 3D simulation in primary breast augmentation: a real-world study of patient-reported outcomes in early independent practice
%A Van Waeyenberge, Michiel
%A De Preter, Elina Kathleen
%A Geeroms, Maxim
%J Annals of Breast Surgery
%D 2026
%B 2026
%9 
%! 3D simulation in primary breast augmentation: a real-world study of patient-reported outcomes in early independent practice
%K 
%X Background: Three-dimensional (3D) simulation has become an increasingly valuable tool in preoperative planning for breast augmentation, offering surgeons and patients an improved understanding of anticipated postoperative outcomes. Despite growing evidence, the majority of plastic surgeons worldwide still do not routinely implement 3D simulation, and data on patient-perceived value, satisfaction, and expectation management in routine clinical workflows remain limited. The objective of this study was to evaluate the real-world clinical utility, patient satisfaction, and perceived predictive reliability of routine 3D simulation in primary breast augmentation.Methods: This retrospective cross-sectional study included consecutive patients undergoing primary breast augmentation with routine preoperative 3D simulation between December 2022 and January 2025. Patient-reported outcomes were collected at 3 months postoperatively using a structured, non-validated questionnaire with 5-point Likert-scale responses. Assessed domains included overall satisfaction, perceived predictive reliability of the 3D simulation, desire to change implant volume, and willingness to recommend the technology. Descriptive statistical analysis was performed.Results: A total of 126 patients were included. Overall postoperative satisfaction was high, with 122 patients (96.8%) reporting satisfaction, including 76 (60.3%) who strongly agreed and 46 (36.5%) who agreed. Perceived predictive reliability of the 3D simulation was reported as reliable or very reliable by 109 patients (86.5%), while 12 (9.5%) were neutral and 5 (4.0%) disagreed. Only three patients (2.4%) wished to upsize their implants postoperatively, and one (0.8%) requested conversion from anatomical to round implants. Notably, no patient felt their implants were oversized. Recommendation behavior was highly favorable, with 116 patients (92.1%) indicating they would recommend preoperative 3D simulation to others. The main limitations to the study are the relatively short follow-up time (mean 8.6 months, with a minimum of 3 months) and the absence of a control group (conventional planning without 3D imaging system).Conclusions: Routine use of 3D simulation in primary breast augmentation was associated with high patient satisfaction, strong perceived predictive reliability, and a low postoperative desire for implant revision. These findings suggest that 3D simulation is a valuable adjunct for expectation management and shared decision-making in clinical practice, particularly during the early phase of independent surgical practice. Key discussion themes include enhanced shared decision-making, the replacement of traditional preoperative and perioperative implant sizers, the value of 3D imaging in addressing asymmetry, aligning expectations, and improving patient education. By outlining both its advantages and limitations, this study offers practical guidance for surgeons seeking to integrate 3D simulation technology into their preoperative workflow.
%U https://abs.amegroups.org/article/view/9848
%V 10
%P 
%@ 2616-2776