Outcomes of Breast Reduction Surgery Using the BREAST-Q: A Prospective Study and Comparison with Normative Data

Crittenden, Tamara; Watson, David I.; Ratcliffe, Julie; Griffin, Philip A; Dean, Nicola R.

doi:10.1097/prs.0000000000006114

Cited by 33 publications

(27 citation statements)

References 45 publications

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“…This is in line with previous reports that have demonstrated similar improvements in domains measured preoperatively, and high scores on all domains overall. 20,21 This result intuitively makes sense, as method of dermal closure would not affect most of the domains measured by the BREAST-Q. Importantly, patients reported similar satisfaction levels with the outcome, nipples, and breast overall, suggesting the use of the DS led to equivalent satisfaction and QoL for patients.…”

Section: Discussionmentioning

confidence: 71%

Use of Absorbable Dermal Stapler in Reduction Mammoplasty: Assessing Technical, Quality-of-Life, and Aesthetics Outcomes

Patel

Green

Christopher

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Introduction: Reduction mammaplasty is a mainstay in the treatment of symptomatic macromastia, with a well-described positive impact on patient quality-of-life (QoL). Absorbable dermal staplers have the potential to improve the efficiency of skin closure in reduction mammoplasties, but a more comprehensive assessment of its impact on key outcomes has not been fully elucidated. Methods: A retrospective review of patients undergoing reduction mammoplasty between November 2018 and December 2020 was conducted. Patients were included if they had undergone a wise-pattern reduction with a superomedial pedicle and completed 3 months of follow-up. Patient demographics, operative information, clinical and aesthetic outcomes, and QoL were compared between patients that had INSORB stapler-assisted and suture-only closures. Results: Seventy-five patients met the inclusion criteria, with 34 patients (45%) in the stapler cohort. Total procedure time was significantly reduced with the use of the dermal stapler (stapler: 154 vs. suture: 170 minutes; p = 0.003). The incidence of major complications was similar between cohorts (stapler: 8.8% vs. suture: 12%; p = 0.64), as was the incidence of minor complications (stapler: 44% vs. suture: 41%; p = 0.82). Regardless of closure technique, patients demonstrated significant increases in all QoL domains (p <0.001). Lastly, 10 independent raters found no difference in the cosmetic appearance of breasts from either cohort, when judging overall breast appearance, shape, scars, volume and the nipple-areolar complex (all p > 0.05). Conclusions:The dermal stapler improves efficiency of closure during reduction mammoplasty without increasing the incidence of wound healing complications. Additionally, cosmetic outcomes are not affected, and patients demonstrate similar post-operative satisfaction with the result regardless of closure technique.

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Section: Discussionmentioning

confidence: 71%

Use of Absorbable Dermal Stapler in Reduction Mammoplasty: Assessing Technical, Quality-of-Life, and Aesthetics Outcomes

Patel

Green

Christopher

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…It is also possible that the overall benefits that patients derive from reduction mammoplasty outweigh the negative impact of potential complications over time. For instance, Crittenden et al 17 observed that by 12 months postoperatively, there were no significant differences in satisfaction with outcome BREAST-Q scores between patients who experienced a complication and those who did not. Notably, complication rates across Wise and vertical incisions have been consistently reported as comparable, including for large volume reductions 43–46 .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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Background Despite the commonly recognized benefits and drawbacks of each surgical technique for reduction mammoplasty, data on the influence of each surgical approach on patient quality of life and satisfaction remains limited. Our study aims to evaluate the association between surgical factors and BREAST-Q scores for reduction mammoplasty patients. Methods A literature review through August 6, 2021, was conducted using the PubMed database to select publications that used the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. The BREAST-Q data were stratified by incision pattern and pedicle type. Results We identified 14 articles that met selection criteria. Among 1816 patients, the mean age ranged from 15.8 to 55 years, mean body mass index ranged from 22.5 to 32.4 kg/m2, and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points (P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points (P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points (P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points (P < 0.0001). No significant correlations were observed when mean difference was modeled against complication rates or prevalence of superomedial pedicle use, inferior pedicle use, Wise pattern incision, or vertical pattern incision. Complication rates were not correlated with preoperative, postoperative, or mean change in BREAST-Q scores. A negative correlation was noted between the prevalence of superomedial pedicle use and postoperative physical well-being (Spearman rank correlation coefficient [SRCC], −0.66742; P < 0.05). The prevalence of Wise pattern incision was negatively correlated with postoperative sexual well-being (SRCC, −0.66233; P < 0.05) and physical well-being (SRCC, −0.69521; P < 0.05). Conclusions Although either preoperative or postoperative BREAST-Q scores may be individually influenced by pedicle or incision type, there was no statistically significant effect of surgical approach or complication rates on the average change of these scores, and overall satisfaction and well-being scores improved. This review suggests that any of the main surgical approaches to reduction mammoplasty provide equally substantial improvements in patient-reported satisfaction and quality of life, but more robust comparative studies would strengthen this area of research.

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“…Specifically, studies have reported significant increases in the sexual well-being BREAST-Q domain for adults following reduction mammaplasty, but the same has not been observed in the adolescent population. 40–42…”

Section: Discussionmentioning

confidence: 99%

Validation of the Short-Form 36 for Adolescents Undergoing Reduction Mammaplasty

McNamara

Parry

Netson

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Health-related quality of life improvements after reduction mammaplasty have been reported by patients. Although instruments exist for adults, a validated outcomes survey is not available for adolescents. This study aims to validate the Short-Form 36 (SF-36) for adolescents undergoing reduction mammaplasty. Methods: Patients aged 12-21 years were prospectively recruited between 2008 and 2021 to unaffected or macromastia cohorts. Patients completed four baseline surveys: SF-36, Rosenberg Self-esteem Scale, Breast-related Symptoms Questionnaire, and Eating Attitudes Test. Surveys were repeated at 6 and 12 months postoperatively (macromastia cohort), and at 6 and 12 months from baseline (unaffected cohort). Content, construct, and longitudinal validity were assessed. Results: A total of 258 patients with macromastia (median age: 17.5 years), and 128 unaffected patients (median age: 17.0 years) were included. Content validity was established, and construct validity was fulfilled: internal consistency was confirmed for all domains (Cronbach alpha >0.7); convergent validity was satisfied through expected correlations between the SF-36 and Rosenberg Self-esteem Scale, Breastrelated Symptoms Questionnaire, and Eating Attitudes Test, and known-groups validity was established through significantly lower mean scores in all SF-36 domains in the macromastia cohort compared with unaffected patients. Longitudinal validity was established by significant improvements in domain scores from baseline to 6 and 12 months postoperatively in patients with macromastia (P < 0.05, all). Conclusions: The SF-36 is a valid instrument for adolescents undergoing reduction mammaplasty. Although other instruments have been used for older patients, we recommend the SF-36 when assessing health-related quality of life changes in younger populations.

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Outcomes of Breast Reduction Surgery Using the BREAST-Q: A Prospective Study and Comparison with Normative Data

Cited by 33 publications

References 45 publications

Use of Absorbable Dermal Stapler in Reduction Mammoplasty: Assessing Technical, Quality-of-Life, and Aesthetics Outcomes

Use of Absorbable Dermal Stapler in Reduction Mammoplasty: Assessing Technical, Quality-of-Life, and Aesthetics Outcomes

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

Validation of the Short-Form 36 for Adolescents Undergoing Reduction Mammaplasty

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