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.