Oklahoma Center for Orthopedic and Multi-Specialty Surgery, Oklahoma City, OK, USA.
Aesthet Surg J. 2010 Nov-Dec;30(6):814-20. doi: 10.1177/1090820X10386900.
Patients with breast hypertrophy often experience a number of physical symptoms (including intertrigo, painful bra strap grooves, upper and lower back pain, shoulder pain, neck pain, arm pain, numbness or pain in the hands, breast pain, and headaches), as well as psychosocial difficulty. Although these preoperative symptoms have been well-documented in the literature, formal postoperative comparisons are rare.
The authors assessed the postoperative physical, psychosocial, and symptomatic changes following vertical reduction mammaplasty in 260 consecutive patients with various levels of breast hypertrophy.
From 2003-2009, questionnaires were administered preoperatively and postoperatively to 260 consecutive patients who had undergone superior pedicle vertical reduction mammaplasty and were not heavy smokers. The vast majority were primary procedures; 6% were revisions. Preoperative evaluation of each patient's suitability for mammaplasty included an assessment for skin quality and the presence of subdermal veins, areola size, quality of breast tissue, nipple position, presence of axillary rolls, and any asymmetry. The questionnaire administered was the 13-symptom severity scale designed by Kerrigan, which is scored on a 0-100 scale; a high score corresponds to fewer and less severe symptoms. The results were calculated by averaging the item scores and linearly transforming the average to the 0-100 scale.
The average amount excised from each breast was 850 g. Patients gave scores to each category both preoperatively and postoperatively. The largest improvements were seen with difficulty finding bras or clothes to fit, painful bra strap grooves, and difficulty running because of breast size. Results for this section were calculated by taking the difference between postoperative and preoperative values for a selected issue. Overall, combining all categories, the average preoperative value was 27.38 and the postoperative value was 96.615. A t-value of 46.0217 with a P-value < .0005 was obtained between the patients' preoperative answers and postoperative answers.
This study had the significant benefit of being performed exclusively by one plastic surgeon, which led to less operator-dependent variability. The patients in this series indicated high levels of satisfaction following vertical reduction mammaplasty. An added benefit was that the women had less scarring than with the inverted-T technique.
乳房肥大症患者常出现多种身体症状（包括间擦疹、疼痛的胸罩肩带压痕、上下背痛、肩痛、颈痛、臂痛、手麻木或疼痛、乳房疼痛和头痛），以及心理社会困难。尽管这些术前症状在文献中已有详细记录，但正式的术后比较却很少见。
作者评估了 260 例不同程度乳房肥大症患者行垂直缩小乳房成形术后的身体、心理社会和症状变化。
2003 年至 2009 年，对 260 例接受上蒂垂直缩小乳房成形术且非重度吸烟者的连续患者进行了术前和术后问卷调查。绝大多数为初次手术，6%为修复手术。每位患者接受乳房成形术的术前评估包括皮肤质量和皮下静脉的存在、乳晕大小、乳房组织质量、乳头位置、腋窝卷的存在以及任何不对称情况。采用 Kerrigan 设计的 13 种症状严重程度量表进行评估，该量表以 0-100 分评分，得分越高表示症状越少越轻。结果通过计算项目得分的平均值并将平均值线性转换到 0-100 分尺度来计算。
每侧乳房平均切除 850 克。患者对每个类别均进行了术前和术后评分。改善最大的是胸罩或衣服的寻找、疼痛的胸罩肩带压痕和因乳房大小而难以跑步的问题。该部分结果通过选择问题的术后和术前值之间的差值来计算。总体而言，结合所有类别，平均术前值为 27.38，术后值为 96.615。患者术前和术后答案之间的 t 值为 46.0217，P 值<.0005。
这项研究的显著优势是由一位整形外科医生专门进行的，这导致了更少的操作者依赖性变异性。该系列患者对垂直缩小乳房成形术表示高度满意。一个额外的好处是，与倒 T 技术相比，女性的疤痕更少。
