Age and Body Mass Index Affect Patient Satisfaction Following Reduction Mammoplasty: A Multicenter Study Using BREAST-Q

Abstract

Background Reduction mammoplasty effectively improves quality of life for women with macromastia. However, little is known whether surgical- or patient-related factors affect satisfaction. Objective The authors sought to investigate factors associated with altered patient satisfaction following reduction mammoplasty. Methods A cross-section study was performed by sending the BREAST-Q Reduction module to all patients who had undergone reduction mammoplasty between January 2009 and December 2018 at 2 tertiary Danish hospitals. Demographics and pre-, peri-, and postoperative details were gathered from electronic medical records. Results A total of 393 patients returned the questionnaire and were eligible for the study. Increasing age at the time of surgery was associated with higher satisfaction with breasts nipples, headache, psychosocial well-being, and outcome. Increased body mass index at the time of surgery negatively affected satisfaction with breasts and psychosocial well-being. Increase in body mass index after surgery was further associated with lower satisfaction with breasts, nipples, sexual well-being, and more pain in the breast area. Postoperative scar revision and wound infection was more common following inferior pedicle technique than superomedial technique and negatively affected satisfaction with outcome and pain in the breast area. Conclusions Patients should be motivated to optimize their weight prior to reduction mammoplasty to achieve optimal satisfaction. Age was associated with improved patient satisfaction, which should considered when operating on younger patients. Postoperative complications affect patient satisfaction, and the superomedial technique seems to be a better choice than the inferior pedicle technique in medium-large breasts. Level of Evidence: 4

A Dutch Cross-sectional Population Survey to Explore Satisfaction of Women with their Breasts

“…Research on the relation between age and BMI on BREAST-Q scores following reduction mammoplasty found similar results and concluded that breast satisfaction decreased with higher BMI and was higher among older women. 26 This could indicate that younger women are more insecure and more occupied with the appearance of their breasts in relation to finding a partner and/or settling with a family whereas older women already have acquired this situation and now have other aspects to be more bothered about, such as their facial appearance.…”

Are Surgical Approaches Correlated With BREAST-Q Score Improvements After Reduction Mammoplasty? A Systematic Review

“…Two studies 24,27 reported preoperative BREAST-Q scores only, 4 studies 20,23,25,26 reported postoperative scores only, and 8 studies 14–19,21,22 reported both preoperative and postoperative scores. The time between reduction and completion of the postoperative BREAST-Q scale varied across articles from less than 3 to 12 months postoperatively, with data not reported from 6 of 14 studies 16,20,23–26 . The length of follow-up time across articles ranged from 6 weeks to 10 years postoperatively, with data not reported from 4 of 14 studies 16,19,24,26 .…”

“…The most commonly used pedicle was superomedial (50.9%, 532/1046), whereas the inferior pedicle was used in 19.8% (207/1046) of the operations. Two articles 19,27 did not differentiate between superomedial/medial and superior/superolateral pedicles and were therefore omitted from overall estimations of prevalence, resulting in 8 of 14 studies included in this estimation 14,17,18,20,22,23,25,26 . However, these two studies were still included in subsequent linear regressions for other pedicle types, which were specified.…”

“…Given that all responses were generated by survey takers, there was inherent risk of response bias, high nonresponse rate, and inadequate validation of reported data by survey participants, which led this study to ultimately qualify as having a high risk of bias. Otherwise, 3 studies 23,25,27 met criteria for low risk of bias, 1 study 22 was considered intermediate risk of bias, and Mundy et al 24 was considered high risk of bias by our assessment.…”

“…The included articles consisted of eight prospective cohort studies, [14][15][16][17][18][19][20][21] 3 cross-sectional studies, [22][23][24] and 3 retrospective chart reviews. [25][26][27] Countries represented included the United States (7), Brazil (2), Australia (1), Austria (1), Denmark (1), Spain (1), and Sweden (1).…”