The purpose of the present study was to describe the outcomes associated with reduction mammaplasty in terms of physical parameters and health-related quality of life. A prospective cohort study was designed and included women undergoing bilateral breast reduction surgery at the Royal Victoria Hospital, Montreal, Quebec, who consented to participate. Women were evaluated preoperatively for symptoms, physical parameters, quality of life (Short Form [SF]-36 and Multidimensional Body Self Relations Questionnaire [MBSRQ]) and general demographic characteristics that were identified as potential confounders. Postoperatively, women were re-evaluated at six months for symptoms, physical parameters and quality of life. A total of 74 women were entered in the study. Their average age was 32.3 years, and the mean mass of resected volume per breast was 630 g. There was a statistically significant improvement in symptoms six months after surgery (P<0.05). There was also a statistically significant improvement in the physical component summary scale of the SF-36 and several additional subscales: bodily pain, physical functioning, role-physical, and vitality. The MBSRQ subscale of appearance evaluation was significantly increased (2.69 compared with 3.12, P=0.000), whereas the appearance orientation subscale was unchanged. The amount of tissue removed did not appear to correlate with the change in physical symptoms or health-related quality of life resulting from the surgery. This study showed significant improvement in physical and psychological aspects of health-related quality of life in women undergoing reduction mammaplasty.
Background Suction lipectomy is the most common aesthetic surgery performed in North America. The safety of the procedure has recently been questioned, particularly with respect to large volume aspiration. Objective To delineate Canadian liposuction practice patterns and perceived complication rates. Subjects and Methods A survey was mailed to all plastic surgeons registered with the Canadian Society of Plastic Surgeons. The survey assessed surgeon demographics, hospital admission rates following liposuction, techniques used, wetting solutions, aspirate volumes and complications. Results A total of 322 surveys were mailed. The response rate was 44%. Of the 142 surgeons who responded, 119 regularly performed suction lipectomy. They reported that 70% of patients had suction lipectomy performed on an outpatient basis. Forty per cent of procedures were performed in private clinics. On average, surgeons performed 40 liposuctions/year without ancillary procedures and 27 liposuctions/year with ancillary procedures. Fifteen per cent of surgeons used ultrasound-assisted liposuction as an adjunct to traditional liposuction, although less than 1% used it exclusively. The ratio of aspirate to infiltrate was 0.25 to one in 45% of cases, 0.5 to one in 37%, one to one in 17% and one to one in fewer than 1%. In 69% of patients, 1 to 2 L was aspirated, while in fewer than 5% of patients, more than 3.5 L was aspirated. Early complication rates were as follows: hematoma and seroma 2.6%, infection 1.3% and skin loss 0.01%. Contour irregularity was the main late complication, occurring in 12% of patients. No cases of venous thrombosis, or pulmonary or fat emboli were reported. No deaths were reported. Conclusions Suction lipectomy is performed commonly by Canadian plastic surgeons, with the majority using a wet or superwet technique. In the vast majority of patients, fewer than 3500 cm3 are aspirated. The complication rate is perceived to be low.
The purpose of the present study was to describe the outcomes associated with reduction mammaplasty in terms of physical parameters and health-related quality of life. A prospective cohort study was designed and included women undergoing bilateral breast reduction surgery at the Royal Victoria Hospital, Montreal, Quebec, who consented to participate. Women were evaluated preoperatively for symptoms, physical parameters, quality of life (Short Form [SF]-36 and Multidimensional Body Self Relations Questionnaire [MBSRQ]) and general demographic characteristics that were identified as potential confounders. Postoperatively, women were re-evaluated at six months for symptoms, physical parameters and quality of life. A total of 74 women were entered in the study. Their average age was 32.3 years, and the mean mass of resected volume per breast was 630 g. There was a statistically significant improvement in symptoms six months after surgery (P<0.05). There was also a statistically significant improvement in the physical component summary scale of the SF-36 and several additional subscales: bodily pain, physical functioning, role-physical, and vitality. The MBSRQ subscale of appearance evaluation was significantly increased (2.69 compared with 3.12, P=0.000), whereas the appearance orientation subscale was unchanged. The amount of tissue removed did not appear to correlate with the change in physical symptoms or health-related quality of life resulting from the surgery. This study showed significant improvement in physical and psychological aspects of health-related quality of life in women undergoing reduction mammaplasty.
A prospective randomized study was designed to address the safety of performing reduction mammaplasty without drains. In the same cohort, the postoperative pain requirements, length of stay and complications were recorded in an effort to document the efficacy of performing this surgery in an outpatient setting. All women presenting for reduction mammaplasty at the Royal Victoria Hospital during a one-year period were asked to participate in the study. A total of 75 patients enrolled, and complete data were available at the 28-day follow-up for all women. The overall hematoma rate was 0% with drains and 2.7% without drains. The observed infection rate was 8% with drains and 5% without drains. There is no statistically significant or clinically meaningful difference in complication rates between breasts treated with drains and those treated without drains. In addition, 90% of women can be managed with oral analgesics within 23 h of surgery. Combined, this information suggests a potential cost savings of 57% based on prestudy observations. Careful analysis of the process of care will continue to enable the care of patients to be more efficient without compromising quality or safety.
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