Original scientific paper
Current Trends in Breast Reduction
Zdravko Roje
Željka Roje
Milan Milošević
Josip Varvodić
Marko Mance
Abstract
Results of our study describe the long term effects of reduction mammaplasty. Many women with excessively small or
large breasts have an altered personal self-image and often suffer from low self-esteem and other psychological stresses.
This procedure is designed to reduce and reshape large breasts, and since the size, shape, and symmetry of a woman’s
breasts can have a profound effect on hermental and physical well-being it is important to observe the patient’s long-term
outcome. Currently, breast reduction surgery is safe, effective and beneficial to the patient. In Croatia, reduction mammoplasty
is often excluded from the general health care plan. The distinction between »reconstructive« versus »cosmetic«
breast surgery is very well defined by the American Society of Plastic Surgeons Board of Directors. Unfortunately, the
Croatian Health Society has yet to standardize such a distinction. There is an imperative need for evidence-based selection
criteria. We retrospectively analyzed data of 59 female patients suffering from symptomatic macromastia who underwent
reduction mammaplasty over a 16 year period (1995 until 2011). Our aim was to compare and contrast the various
techniques available for reduction mammaplasty and to determine, based on patient outcome and satisfaction, which
technique is most suited for each patient. The results of our study generally reinforce the observation that reduction
mammaplasty significantly provides improvements in health status, long-term quality of life, postsurgical breast appearance
and significantly decrease physical symptoms of pain. A number of 59 consecutive cases were initially treated
with the four different breast reduction techniques: inverted-T scat or Wisa pattern breast reduction, vertical reduction
mammaplasty, simplified vertical reduction mammaplasty, inferior pedicle and free nipple graft techniques. The average
clinical follow-up period was 6-months, and included 48 patients. The statistical analysis of the postoperative patient
complications revealed a significant positive relationship in regards to smoking. The majority of these complications
were wound related, with no significant relationship between patient complications and variables such as age,
BMI, ASA score, resection weight of breast parenchyma, nipple elevation, duration of surgery, and type of pedicle. The
higher number of complication correlated with a lower volume of parenchyma resection (rho=–0.321). Overall satisfaction
with the new breast size (79%), appearance of the postoperative scars (87%), overall cosmetic outcome score (91%),
overall outcome (100%), psychosocial outcome (46%), sexual outcome (85%), physical outcome (88%), satisfaction with
preoperative information data (92%), and finally satisfaction with overall care process (96%) was calculated. As expected,
the physical symptoms disappeared or were minimized in 88% of patients. Each method of breast reduction has
its advantages and disadvantages. The surgeon should evaluate each patient’s desires on the basis of her physical presentation.
Breast reduction surgery increases the overall personal and social health; not only for the patient, but for their
family and friends as well. It is an imperative that every surgeon is aware of this, in order to provide the highest level of
care and quality to their patients.
Keywords
breast hypetrophy; breast reduction surgery; operative techniques; outcome results; patient satisfaction; and quality of life
Hrčak ID:
84945
URI
Publication date:
10.7.2012.
Visits: 1.771 *