Aesthetic surgery journal
September 1, 2026 · via Europe PMC
Current Concepts and Emerging Technologies in Aesthetic Outcome Assessment of Breast Reconstruction.
Lyu D, Vollbach FH, Mesas Aranda I, +6 more, Moellhoff N.
AI summary — for doctors, generated from the abstract only
A systematic review of 51 studies (7,711 participants) found that BREAST-Q remains the most commonly used tool for assessing aesthetic outcomes after breast reconstruction, with a growing but still incomplete shift toward incorporating objective methods like 3D imaging and AI-based analysis.
What was studied
A systematic review of studies evaluating aesthetic outcomes after implant-based, autologous, or hybrid breast reconstruction (2000-2025), classifying assessment tools as subjective or objective and extracting assessment characteristics, aesthetic outcome domains, and patient-centered outcomes, with risk of bias assessed via the Joanna Briggs Institute checklist and evidence levels per the Oxford Centre for Evidence-Based Medicine.
Key findings
- 51 studies involving 7,711 participants from 16 countries were included; subjective tools were most frequently used, led by BREAST-Q (69% of studies), followed by expert/panel-based evaluations (33%) and visual analog scale (4%).
- Objective methods were applied in 19 of 51 studies, including 3D surface imaging (16%), BCCT.core (14%), eye tracking (6%), and AI-based analyses (6%).
- The review describes a progressive shift toward multimodal evaluation, noting that no single modality comprehensively addressed all aesthetic domains.
Clinical relevance
This review may be relevant to clinicians and researchers selecting outcome assessment tools for breast reconstruction, reinforcing BREAST-Q's central role for capturing patient-centered perspectives while highlighting emerging objective technologies that may complement it, as the authors suggest future research should integrate both approaches.
Who should care
Limitations
As a systematic review summarizing heterogeneous studies with varying designs and populations, it does not provide pooled quantitative outcome estimates; the evidence level is rated 3 (Therapeutic) by the authors, reflecting the generally lower-tier evidence typical of outcome assessment literature.
BREAST-Q remains the dominant tool for assessing breast reconstruction aesthetic outcomes, though objective technologies like 3D imaging and AI analysis are increasingly being incorporated alongside it.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
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.
DOI
10.1093/asj/sjag101
PMID
42159042
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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