The Female Breasts .. more or less

Abstract

BackgroundA retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs.the inverted-T scar reduction mammaplasty) remains stable in the long term: MethodsSixty-nine patients who had undergone breast reduction surgery in the period 1997 -2000 at the Department of Reconstructive Plastic Surgery at the Medical Center of Leeuwarden were willing and able to participate in this study. A structured questionnaire was used to assess the degree of patient satisfaction. For subjective evaluation, the Strasser Grading System on photographs at the 3 months after surgery and after long-term follow-up (10 years) was used. ResultsThe median general appreciation mark for the entire surgical procedure given by patients was 8 (1-10) on a scale from 1 to 10. Forty-six of the 69 patients could be scored according to Strasser: at 3 months in 17 patients (37%) the result was 'good', in 21 patients (46%) 'mediocre' and in eight patients (17%) 'poor'. After 10 years, in 37 of the patients (80%) the result was 'good', in six patients (13%) 'mediocre' and in three patients (7%) 'poor'. At 3 months, there was a higher incidence of bottoming out in the vertical scar group (50%) as compared to the inverted-T scar group (10%); however, at the 10-years follow-up bottoming out was 50% in the inverted-T scar group and 20% in the vertical scar group. ConclusionDespite bottoming out, in both the vertical scar reduction mammaplasty technique and the inverted-T scar reduction mammaplasty technique high patient satisfaction rates are achieved that remains for years. SUMMARY BackgroundAlmost every female shows some degree of breast asymmetry. A complete correction of asymmetry is not achievable; the best a surgeon can deliver is improvement of symmetry. This study was undertaken to evaluate to which extent breast asymmetry is influenced by dual-sided breast surgery and whether there is difference between breast augmentation and breast reduction surgery. MethodsOf fifty breast augmentation and fifty breast reduction patients, the pre-and postoperative photographs were evaluated on several aspects of asymmetry by a scoring panel. ResultsPreoperatively, significantly more breast asymmetry was found in the breast reduction group; the total preoperative asymmetry score was 1.7 in the breast augmentation group compared to 3.4 in the breast reduction group (p <0.001). The total asymmetry score after breast reduction improved 0.96 points (95% confidence interval [95%CI] -2.08 to 0.16), which was mainly driven by the significant improvement of breast volume asymmetry (-1.06; 95%CI -1.50 to -0.61). ConclusionsWe found more preoperative asymmetry in the breast reduction group than in the breast augmentation group. We showed that more improvement through surgery can be expected when preoperative asymmetries are more pronounced. Consequently, we found improvement of breast volume asymmetry scores in the breast reduction group, and a trend for improvement of the ...