Rochester, N.Y. From the Division of Plastic Surgery, Life after Weight Loss Program, University of Rochester Medical Center.
Plast Reconstr Surg. 2011 Sep;128(3):643-650. doi: 10.1097/PRS.0b013e318221da6b.
Reduction mammaplasty is often performed on obese women. With the rise in bariatric procedures, secondary changes to breast contour are increasing. This study aims to investigate the temporal relationships of breast contour satisfaction with weight status.
One hundred ninety patients were examined. Patient demographics, comorbidities, body mass index, surgical history, and weight loss method used were evaluated. Patients who underwent reduction mammaplasty before massive weight loss were selected and administered a telephone survey (group I). Patients who did not undergo breast surgery before massive weight loss were selected as a control group (group II).
Of the 15 patients (7.9 percent) in group I, 14 completed the survey (93 percent). For group I, all patients felt the appearance of their breasts improved after reduction (p < 0.001) but felt appearance worsened or stayed the same after weight loss (p = 0.003). Seventy-one percent of patients were able to exercise more and 64 percent were able to lose weight on their own because of their reduction. For group II, 79 percent of patients felt the appearance of their breasts worsened or stayed the same after massive weight loss (p = 0.03).
Most reduction patients before massive weight loss are glad they had the reduction and become more active but ultimately needed bariatric surgery to accomplish weight loss goals and are dissatisfied with breast contour following massive weight loss. Thus, patients who are considering bariatric procedures should be encouraged to pursue that operation before proceeding with reduction mammaplasty.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
缩乳术通常在肥胖女性中进行。随着减重手术的增加，乳房轮廓的继发性变化也在增加。本研究旨在探讨乳房轮廓满意度与体重状况的时间关系。
检查了 190 名患者。评估了患者的人口统计学、合并症、体重指数、手术史和使用的减肥方法。选择了在大量体重减轻前接受缩乳术的患者，并对其进行了电话调查（I 组）。选择未在大量体重减轻前进行乳房手术的患者作为对照组（II 组）。
I 组的 15 名患者（7.9%）中，有 14 名完成了调查（93%）。对于 I 组，所有患者在缩乳术后均感到乳房外观改善（p<0.001），但在体重减轻后感到外观恶化或保持不变（p=0.003）。71%的患者能够因缩乳术而更积极地运动，64%的患者能够自行减肥。对于 II 组，79%的患者在大量体重减轻后感到乳房外观恶化或保持不变（p=0.03）。
大多数在大量体重减轻前接受缩乳术的患者很高兴进行了缩乳术，并变得更加活跃，但最终需要进行减重手术才能实现减肥目标，并对大量体重减轻后乳房轮廓不满意。因此，应鼓励考虑进行减重手术的患者在进行缩乳术前进行该手术。
临床问题/证据水平：治疗性，II 级。
