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Understanding the Effect of Breast Augmentation on Quality of Life: Prospective Analysis Using the BREAST-Q

Alderman, Amy K. M.D., M.P.H.; Bauer, Joseph M.D.; Fardo, Dean M.D.; Abrahamse, Paul Ph.D.; Pusic, Andrea M.D., M.S.

Plastic and Reconstructive Surgery: April 2014 - Volume 133 - Issue 4 - p 787–795
doi: 10.1097/PRS.0000000000000023
Cosmetic: Outcomes Article
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Background: The aim of this study was to prospectively evaluate patient satisfaction and quality of life with elective breast augmentation.

Methods: Patients with bilateral submuscular breast augmentations prospectively completed the BREAST-Q preoperatively and 6 weeks and 6 months postoperatively; t tests compared preoperative and postoperative scores at 6 weeks and 6 months, and standard indicators of effect sizes were calculated. Logistic regression was used to evaluate the association between patient and surgical factors on satisfaction outcomes.

Results: The study sample included 611 female patients with the following characteristics: (1) mean age of 33.5 years; (2) mean body mass index of 21.7; (3) and mean implant volume of 360; with (4) 73 percent having received a silicone implant. Significant improvements were found in patient satisfaction with breasts (p < 0.001), psychosocial well-being (p < 0.001), and sexual well-being (p < 0.001) at 6 weeks and 6 months postoperatively, and all were associated with a very large Kazis effect size of 3.66, 2.39, and 2.56 at 6 months, respectively. However, at both 6 weeks and 6 months postoperatively, physical well-being remained significantly below preoperative baseline scores. In addition, satisfaction with breasts and with the overall surgical experience was significantly lower among older patients (p = 0.01 and 0.02, respectively).

Conclusions: Breast augmentation is associated with high patient satisfaction and significant improvements in quality of life. However, physicians should inform patients that submuscular augmentations are associated with a delay in recovery of physical functioning and be aware that older patients may experience diminished satisfaction and should counsel accordingly.


Atlanta, Ga.; Ann Arbor, Mich.; and New York, N.Y.

From private practice; University of Michigan; and Memorial Sloan-Kettering Cancer Center.

Received for publication June 25, 2013; accepted September 18, 2013.

Disclosure: Drs. Fardo and Abrahamse have no conflicts. Drs. Alderman and Bauer have consulting agreements with Mentor. Dr. Pusic is co-developer of the BREAST-Q, which is owned by Memorial Sloan-Kettering Cancer Center and the University of British Colombia. In accordance with the inventor-sharing policies of these institutions, she receives a portion of licensing revenues when the BREAST-Q is used in industry-sponsored clinical trials.This work was supported by Mentor.

Amy K. Alderman, M.D., M.P.H., 4165 Old Milton Parkway, Suite 200 East, Alpharetta, Ga. 30005,

©2014American Society of Plastic Surgeons