Although there are many three-dimensional imaging systems currently available on the market, all of them require a high degree of interaction on the part of the user, making them clinically impractical. Moreover, though claims have been made regarding the validity of these systems for imaging the breast form, there have been no previous reports validating any commercially-available implant simulation models in the plastic surgery literature. In this article, the authors describe the development and evaluate the efficacy of a novel four-dimensional (automated three-dimensional) breast imaging system, validating it as an evidence-based simulation tool for patient consultation, surgical planning, and outcomes analysis in cosmetic breast augmentation. This report, based on a series of longitudinal correlation studies with several patient cohorts, found a highly statistically significant degree of correlation and reliability between the automated measurements obtained with the four-dimensional system and manual measurements.