Artificial intelligence in breast reduction surgery: a review of preoperative planning, intraoperative assessment and postoperative outcome prediction

Abstract

According to the German Association of Aesthetic Plastic Surgeons (VDÄPC, 2024), breast reduction surgery is among the most frequently performed plastic surgical procedures on the female breast. The primary goal of this operation is to reduce the volume of glandular and adipose tissue and to reposition the nipple-areola complex, for example, in cases of hypertrophic breasts. Indications include both functional impairments - such as chronic pain in the upper spine or recurrent intertriginous dermatitis in the inframammary fold - and aesthetic concerns. The first documented breast reduction procedures date back to the mid-19th century and have since undergone continuous evolution. To this day, there is no standardized protocol for preoperative marking, resulting in significant variability among clinics and surgeons. In recent years, artificial intelligence (AI) has gained increasing relevance in clinical practice, especially in enhancing diagnostic processes, surgical planning, and outcome prediction. This narrative review examines the current literature on the integration of digital solutions and AI into breast reduction surgery. The objective is to identify current applications, explore the potential of AI-assisted technologies in preoperative planning and assessment, and provide a perspective on future developments. By doing so, this article aims to contribute to the structured evaluation of the interdisciplinary interface between plastic surgery and digital innovation. It highlights the potential of AI to enable standardized, personalized, and precise surgical planning in breast reduction procedures, ultimately improving clinical outcomes and patient satisfaction.

Keywords

AI-assisted surgical planning / breast surgery / reduction mammaplasty / surgical standardization / preoperative marking

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