Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

Background: The objective of the study was to evaluate surgical and aesthetic outcomes of bilateral reduction mammoplasty (RM) through the inferior pedicle with inverted-T approach (PO).Methods: 23 women with bilateral symptomatizing macromastia underwent preoperative breast measurements, calculation of breast volume (BV), determination of quality of life (QoL) and self-esteem scorings using the breast reduction assessed severity scale (BRASS) and the Rosenberg self-esteem scale (RSES). RM was performed and intraoperative and PO data were collected. At 3-m PO, aesthetic outcome was evaluated using the ABNSW score, which assesses breasts asymmetry and shape, nipple deformation, skin condition and wound scar, and QoL outcome and overall satisfaction were determined.Results: Mean operative time was 240.4±39.7 min and mean weight of excised breast tissue was 2778.3±307.7 gm. Minor PO complications were managed conservatively and no patient required revision surgery. PO breast measurements were significantly improved with decreased BV and increased breast projection. Median ABNSW score was 10 and PO median BRASS and RSES scores were 9 and 17 with significant change in comparison to preoperative data. Preoperative BRASS score was negatively correlated age and body mass index, while RSES score was positively correlated with age. Nine women were highly satisfied by aesthetic outcome, 10 women were satisfied and 16 women were highly satisfied with overall outcome.Conclusions: RM significantly improved women QoL, aesthetic appearance and psychological status. Inferior pedicle with inverted T-mammoplasty is a safe, and applicable pattern of mammoplasty, allow significant reduction of BV with improved breast measurements and projection and provide satisfactory aesthetic outcome.

Age and Body Mass Index Affect Patient Satisfaction Following Reduction Mammoplasty: A Multicenter Study Using BREAST-Q

Background Reduction mammoplasty effectively improves quality of life for women with macromastia. However, little is known whether surgical- or patient-related factors affect satisfaction. Objective To investigate factors associated with altered patient satisfaction following reduction mammoplasty. Methods A cross-section study was performed by sending the BREAST-Q Reduction module to all patients, whom had undergone reduction mammoplasty between January 2009 and December 2018 at two tertiary Danish hospitals. Demographics, pre-, per- and postoperative details were gathered from electronic medical records. Results 393 patients returned the questionnaire and were eligible for the study. Increasing age at the time of surgery was associated with higher satisfaction with breasts (p<0.001), nipples(p<0.001), headache(p <0.05), psychosocial well-being(p<0.001), and outcome(p<0.05). Increased BMI at the time of surgery negatively affected satisfaction with breasts(p<0.05) and psychosocial well-being(p<0.05). Increase in BMI after surgery was further associated with lower satisfaction with breasts(p<0.05), nipples(p<0.05), sexual well-being(p<0.05), and more pain in the breast area(p<0.05). Postoperative scar revision and wound infection was more common following inferior pedicle technique than superomedial technique(p<0.05) and negatively affected satisfaction with outcome(p<0.05) and pain in the breast area(p<0.05). Conclusion Patients should be motivated to optimize their weight prior to reduction mammoplasty to achieve optimal satisfaction. Furthermore, reduction mammoplasty can benefit obese patients by facilitating subsequent weight loss for additional satisfaction. Age was associated with improved patient satisfaction and this should considered when operating on younger patients. Postoperative complications affect patient’s satisfaction and the superomedial technique seems to be a better choice than the inferior pedicle technique in medium-large breasts.