Clinical outcome, quality of life, patients’ satisfaction, and aesthetic results, after reduction mammaplasty

Abstract

Macromastia is a common indication for breast reduction within the public health care system in Sweden. To reduce the waiting time, a project was launched to operate on patients during a three-month period at a local hospital in Stockholm (Nacka Hospital). The operations were done by specialists and residents from the Karolinska University Hospital, using a medial flap technique. The aim of this prospective study was to evaluate the results of this project, focusing on clinical outcome, quality of life, patients' satisfaction, and aesthetic results. Personal and preoperative clinical data and information about risk factors were extracted from the patients' records. At the 6 month follow-up the patients were asked to fill in two questionnaires: "Short Form-36" and another form about patients' satisfaction and sensitivity. Four digital photos taken during the follow-up were graded by three plastic surgeons. Diabetes and oral contraceptives, respectively, were risk factors for infection and delayed wound healing. Patients reported a significantly increased quality of life after six months, regardless of body mass index. Patients were generally more satisfied with the aesthetic outcome than were the surgeons, had satisfactory aesthetic results (89%), acceptable levels of complications (31%), and increased quality of life. The medial flap technique should be evaluated further for its loss of sensitivity.

Reduction Mammaplasty, Obesity, and Massive Weight Loss

“…1 Breast reduction has been shown to improve many of the symptoms caused by macromastia, including neck, back, and shoulder pain; shoulder grooving; skin rashes; mastodynia; unwillingness to exercise; feelings of physical unattractiveness; poor sexual satisfaction; and poor quality of life. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] After breast reduction, patients are more likely to exercise and lose weight. In a survey of 41 patients, Singh et al noted that 63 percent reported reduction mammaplasty was a stimulus for weight loss, and these patients had significantly increased exercise.…”

“…The benefits of reduction mammaplasty include the increased ability to exercise, 12 improved quality-of-life outcomes, and overall satisfaction with breast contour. [3][4][5] Many patients undergoing breast reduction surgery, however, are obese. 17,18 Currently, there is an ongoing movement in the United States to combat obesity, with greater numbers of people undergoing bariatric procedures.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Common complaints include back pain, shoulder pain, neck pain, bra-strap grooving, and intertrigo under the breasts. The benefits of reduction mammaplasty include the increased ability to exercise, 12 improved quality-of-life outcomes, and overall satisfaction with breast contour.…”

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

“…In adult women, reduction mammaplasty resolves breast-related symptoms and improves self-esteem, eating behaviors, and overall HRQOL. 2,7,9,11,[16][17][18][19][20][21][22][23] Alternatively, nonsurgical methods of macromastia treatment such as weight loss have been shown to be ineffective. 4 Reduction mammaplasty, therefore, has become the standard of care for adult women with macromastia.…”

“…Reduction mammaplasty, surgical reduction of breast size, is the most effective means of improving symptoms and HRQOL in adults. 2,4,[6][7][8]13,14,[16][17][18][19][20][21][22][23][24][25] However, many parents and physicians are reluctant to consider surgical correction for adolescents. 26,27 Data on the impact of macromastia on younger patients are needed to better inform health care providers, patients, and families in making appropriate treatment decisions.…”