Breast Reconstruction Morphology Evaluation Tool: Vibe Coding Empowers Clinicians as Creators.

Breast reconstruction aims to restore symmetry and improve quality of life; However, although several morphological assessment methods exist, their need for specialized software, cost, and lengthy processing time reduces their practicality in clinical settings. Recent advances in artificial intelligence have enabled vibe coding, in which clinicians express intent in natural language, and artificial intelligence generates executable code, allowing the development of no-/low-code, clinician-driven software. Using this approach, we created the breast symmetry analyzer (BSA), an end-to-end application that standardizes 3-dimensional morphological analysis. The BSA workflow includes STL import and trimming, automated generation of a virtual chest-wall plane and mirror plane, mirroring and superimposition, vertex-level correspondence, root mean square distance calculation, conversion to a standardized 0%-100% symmetry score, and 3-dimensional color-map visualization. Feasibility was evaluated using a mannequin dataset and a clinical case of latissimus dorsi flap with immediate fat transfer. Each dataset was independently processed 3 times by 2 raters to assess intra- and interrater reproducibility. The BSA successfully produced symmetry scores (83.05% for the mannequin, 87.70% for the clinical case) and color-map visualizations, completing each analysis in less than 45 seconds. Repeated measurements demonstrated minimal variability and excellent reproducibility between raters. The BSA consolidates previously fragmented analytical steps into a single automated workflow, reducing operator dependence and enabling efficient, objective morphological assessment. Beyond this specific application, this study indicates that vibe coding may enable clinicians to translate clinical insight into functional software, potentially transforming them from passive users to active creators in medical technology development.