BACKGROUND: In autologous breast reconstruction accomplishing aesthetically pleasing outcomes represents an integral challenge. Three-dimensional (3D) technology may aid in accurate flap shaping and subsequent breast appearance. OBJECTIVES: The aim of this study was to evaluate the applicability of 3-dimensional technology for surgical planning and its influence on outcomes for breast reconstruction. METHODS: Outcomes of 50 female patients who underwent deep epigastric artery perforator flap breast reconstruction were analyzed. The patient population was divided into 2 study groups (with 3D technology vs without), including 25 patients each. Based on individual 3D scans and simulations, patient-specific templates were utilized intraoperatively in the 3D group. Quality of life assessment and aesthetic evaluations of breast appearance were statistically evaluated and compared. RESULTS: Various scales of the BREAST-Q showed statistically significantly better values in the 3D group (P <
.05). Concerning breast appearance, patients with 3D technology rated their breast shape and projection statistically significantly higher compared to the control group (P <
.05). In addition, blinded ratings of external plastic surgeons were statistically significantly higher related to shape, symmetry, and projection of breasts with 3D technology (P <
.05). All patients treated with 3D technology-assisted breast reconstruction strongly recommended this approach. CONCLUSIONS: Patient-specific templates represent a practical method for facilitating personalized flap planning and shaping. Results demonstrated that 3D technology significantly enhances breast reconstruction outcomes concerning aesthetics and postoperative quality of life.