Primary Breast Augmentation with Autologous Fat Grafting Alone: Evaluation of Patient Satisfaction Using the BREAST-Q

Abstract

Background Autologous fat grafting (AFG) for primary aesthetic breast augmentation has grown in popularity over recent years but patient satisfaction has never been objectively evaluated. Objectives The aim of the present study was to use the standardized BREAST-Q questionnaire to evaluate satisfaction in patients who had received primary aesthetic breast augmentation with AFG alone. Methods All recipients of primary aesthetic breast augmentation by AFG performed between 2013 and 2017 in our plastic surgery department were included. The primary endpoint was assessment of patient satisfaction with the standardized breast augmentation BREAST-Q questionnaire. Three additional questionnaires were used to evaluate patient and surgeon satisfaction. Results In total, 42 patients (84 breasts) underwent breast augmentation by AFG. Mean patient age was 34 years (range, 23-53 years). The mean volume of reinjected fat was 312.2 mL per breast (range, 130-480 mL). We observed significant improvement in all BREAST-Q postoperative items (excluding physical well-being) with a mean increase of 39 points (95% confidence interval: 28.97, 49.03; P < 0.001) regarding patient satisfaction with breasts. Overall, 82% of patients were satisfied with the result of their liposuction. Minor complications were encountered in 6 of our patients (14%). Conclusions Breast augmentation by AFG enhances patient satisfaction as measured by the BREAST-Q. This procedure has a high satisfaction rate and improves quality of life. Breast augmentation by AFG is a valid surgical option for moderate breast augmentation but is not an alternative to implants in large breast augmentation. Level of Evidence: 4

Surgery of congenital breast asymmetry—which objective parameter influences the subjective satisfaction with long-term results

“…Especially in earlier studies, some authors worked with a simple satisfaction scale [10,35,37,38] or used measurement tools that did not specifically refer to the breast [14]. In recent years, however, the breast-specific Breast Q ™ has increasingly replaced these and is used frequently in research [24,[32][33][34]. Critically, however, it should be noted that long-term outcome satisfaction as assessed by the Breast Q ™ is a very complex construct [39] and may be influenced by many other individual factors besides those assessed in this study.…”

“…It is thus considered a clinically relevant, standardized outcome evaluation instrument that meets psychometric criteria and captures the patient's self-assessment according to a state-of-the-art system [31]. Recently, Breast Q ™ was also used by other researchers in similar studies [32,33].…”

“Surgery of Congenital Breast Asymmetry – Which Objective Parameter Influences the Subjective Satisfaction With Long-term Results?”

“…Especially in earlier studies, some authors worked with a simple satisfaction scale [10,35,37,38] or used measurement tools that did not speci cally refer to the breast [14]. In recent years, however, these have been increasingly replaced by the breast speci c BreastQ™ and frequently used in the research community [24,[32][33][34]. Critically, however, it should be noted that long-term outcome satisfaction as assessed by the BreastQ™ is a very complex construct [39] and could be in uenced by many other individual factors besides those assessed in the present study.…”

“…Over ve years the Breast Q™ was validated with the help of about 3000 women [31]. It is therefore considered a clinically relevant standardised outcome evaluation instrument that meets psychometric criteria and assesses the patient's self-assessment according to a state-of-the-art system [31] and has recently been used by other researchers in similar studies [32,33].…”

Patient-Reported Outcomes after Subpectoral Breast Augmentation with Microtextured or Macrotextured Implants Using the BREAST-Q

“…6 It is important to assess the opinion of patients on the surgical results using instruments that provide a reliable quantification of subjective outcomes resulting from the cosmetic procedure. [7][8][9][10][11] The BREAST-Q assesses patient satisfaction with the surgical outcome through the "satisfaction with breasts," "satisfaction with overall outcome," and "satisfaction with care" domains, as well as quality of life, as measured through the "psychosocial well-being," "sexual well-being," and "physical well-being" domains. BREAST-Q domains may be evaluated together or independently.…”