How reliable is breast implant Vectra imaging? (photo)

Thank you for the question.
There are several steps taken to select a specific size/profile breast implant for a specific patient.  Generally speaking, although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are NOT very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology… are all useful, but not necessarily as accurate as one would hope.
In my opinion, nothing will replace careful verbal and visual aid assisted preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.
In my practice, I use all of the above modalities and then use intraoperative temporary sizers to help determine the best breast implant size/profile to achieve a patient's specific goals as closely as possible. For this reason, I think it is helpful to have the entire range of breast implant sizes/profiles available in the operating room.
Achieving realistic expectations prior to proceeding to the operating room is also an important part of the preoperative communication process. Patients should be aware that the results of their breast augmentation will not necessarily match exactly what they are visualizing with anyone of the above-mentioned communication tools.
 
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or  "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Great question!  Although the vectra imaging gets very close to the actual size, nothing can guarantee exact precision.  Think of it as providing the surgeon an idea of what you are looking for, but understand that surgeons will try their best to get close, but it will never be exact. Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

The short answer is 'not bad'. It just depends whether or not you understand the limitations of the software. Exact sizing is the weak point because the machine cannot account for tissue types, age, parity and other factors. I actually use the machine to show how implants which are too large can cause problems. It is also useful for  the patient to see their native breast (no implants) from a 'distance' and recognize the asymmetries, body types, and other things that they may not see in the mirror at home. One thing about the VECTRA machine is that it is a 'time intensive' exercise and the surgeon has to spend a substantial time with the patient to demonstrate the meanings of the results. This is why, I think, many surgeons call it 'not valuable'.Hope this helps.BTW, it does not substitute for see the surgeon's own patient pictures or speaking with his/her patients.