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A Prospective Study of Short- and Long-Term Cosmetic Outcome after Reduction Mammaplasty from Three Different Perspectives: The Patient, a Department Surgeon, and an Independent Private Practitioner in Plastic Surgery

Breiting, Line Bro M.D.; Henriksen, Trine Foged M.D., Ph.D.; Kalialis, Louise Vennegaard M.D.; Gramkow, Christina M.D.; Høyer, Anette Pernille M.D., Ph.D.

Plastic and Reconstructive Surgery: August 2012 - Volume 130 - Issue 2 - p 273–281
doi: 10.1097/PRS.0b013e3182589bbf
Breast: Original Articles
Press Release

Background: Numerous studies have examined the outcome of reduction mammaplasty. This study evaluates the cosmetic outcome after reduction mammaplasty from the perspective of the patient, a ward surgeon, and a private practitioner in plastic surgery, and analyzes which factors influence it.

Methods: The material stems from a Danish quality assurance program in the public health care system. Nonparametric statistics and logistic regression were used to compare cosmetic outcomes and possible confounding.

Results: Over 80 percent of the patients evaluated the short- and long-term cosmetic outcome as good or very good. The surgeons and especially the private practitioner were more critical. The evaluation of breast features also differs between patients and surgeons. The main issue for patients is symmetry. With time, patients and the private practitioner become more critical about the scars. Surgeons are most concerned about nipple bottoming out. Predictive factors for surgeons were the patient's age, body mass index, and postoperative complications. Evaluation by patients was, in addition to complications, influenced by the preoperative information given, confidence in the treatment, and the overall course on the ward.

Conclusions: Patients evaluate cosmetic outcome significantly more favorably than surgeons and especially the private practitioner. They are also concerned about different breast features. Decreased nipple sensation does not influence the patient's evaluation. Evaluation by the surgeons depends on more objective measures than does evaluation by the patients. One must not underestimate the importance of factors such as preoperative information about the surgery and complications, together with proper and qualified care.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Herlev, Copenhagen, and Roskilde, Denmark

From the Department of Plastic Surgery, Herlev, Copenhagen University Hospital, Denmark.

Received for publication November 7, 2011; accepted February 27, 2012.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Line Bro Breiting, M.D.; rbkgrds Alle 204, 2970 Hørsholm, Denmark, line.breiting@gmail.com

©2012American Society of Plastic Surgeons