Objective
This retrospective study investigates the application of pre-operative 3D surface imaging in breast cancer patients undergoing implant-based augmentation after mastectomy along with simultaneous contralateral balancing surgery. Post-operative cosmetic results were also assessed objectively.

Material and Methods
Breast cancer patients who received implant-based augmentation after mastectomy along with simultaneous contralateral balancing surgery from January 2019 to December 2022 in Taipei Veterans General Hospital were collected retrospectively. The evaluation of cosmetic outcomes were conducted through the utilization of breast cancer conservative treatment (BCCT.core) models.

Results
12 female patients (mean age 46±9 years) were enrolled in this study. Among them, 7 patients underwent nipple-sparing mastectomy, while 5 underwent non-nipple sparing mastectomy. Histology analysis revealed 10 patients had invasive ductal carcinoma and 2 patients had ductal carcinoma in situ. Immediate reconstruction with a tissue expander was performed in 11 patients during mastectomy, whereas 1 patient underwent delayed reconstruction. Data from the BCCT.core was successfully retrieved from 9 patients. Cosmetic outcomes were assessed postoperatively, revealing that 8 patients achieved good to excellent results, while only 1 patient received a fair rating.

Conclusions
Achieving symmetry in implant-based augmentation after mastectomy, particularly when coupled with simultaneous contralateral balancing surgery, can be challenging. However, the integration of pre-operative 3D surface imaging proves to be a convenient and reliable method in breast surgery. Utilizing pre-operative 3D surface imaging has demonstrated its effectiveness, leading to the attainment of good to excellent cosmetic results in the majority of patients.

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