Minneapolis, Minn.; and Milwaukee, Wis. From the Division of Plastic Surgery, University of Minnesota, and the Department of Plastic Surgery, Medical College of Wisconsin.
Plast Reconstr Surg. 2012 Dec;130(6):1352-1359. doi: 10.1097/PRS.0b013e31826d9f66.
The purpose of this study was to determine the current preferences of plastic surgeons regarding preoperative assessment and their effect on clinical outcome in primary breast augmentation.
An eight-question online survey was sent to members of the American Society of Plastic Surgeons. Data collected online were analyzed using Student's t test or Pearson's chi-square test. A value of p < 0.05 was considered statistically significant.
The response rate was 20.1 percent (604 respondents). Breast base diameter [n = 286 (47.4 percent)] was ranked the most important consideration vital in choosing implants. Most surgeons chose to reeducate their patients to resolve a conflict between their patient's implant size request and the surgeon's clinical judgment [n = 385 (63.7 percent)], whereas 151 (25 percent) would proceed anyway. Those surgeons who chose reeducation ranked breast base diameter as a vital consideration significantly higher than those who would accommodate their patients (2.03 ± 1.41 versus 2.31 ± 1.41; p = 0.041). Similarly, surgeons who reeducated their patients ranked implant volume as the vital consideration significantly lower than those who accommodated their patients (2.90 ± 1.67 versus 2.44 ± 1.47; p = 0.002). Regarding size change, 332 surgeons (55 percent) reported their rate was 5 percent or less, whereas 272 (45 percent) reported it was greater than 5 percent. Surgeons who reported a 5 percent or less rate ranked implant volume significantly lower than those with reoperation rates greater than 5 percent (2.93 ± 1.71 versus 2.55 ± 1.53; p = 0.004).
Breast base diameter and implant volume were the two most important considerations in choosing an implant for breast augmentation. Reported reoperation rates for size change were significantly lower for surgeons who regarded breast base diameter as more vital than those who valued implant volume more.
本研究旨在确定整形外科医师对原发性乳房增大术前评估的当前偏好及其对临床结果的影响。
向美国整形外科学会的成员发送了一个包含 8 个问题的在线调查。在线收集的数据使用学生 t 检验或 Pearson 卡方检验进行分析。p 值<0.05 被认为具有统计学意义。
回复率为 20.1%（604 名受访者）。乳房基底部直径[n=286（47.4%）]被列为选择植入物时最重要的考虑因素。大多数外科医生选择重新教育他们的患者，以解决患者的植入物大小要求与外科医生的临床判断之间的冲突[n=385（63.7%）]，而 151 名（25%）会不顾这一冲突继续手术。选择重新教育的外科医生将乳房基底部直径列为重要考虑因素的排名明显高于那些愿意满足患者要求的医生（2.03±1.41 对 2.31±1.41；p=0.041）。同样，重新教育患者的外科医生将植入物体积列为重要考虑因素的排名明显低于那些满足患者要求的医生（2.90±1.67 对 2.44±1.47；p=0.002）。关于尺寸变化，332 名外科医生（55%）报告他们的比例为 5%或更低，而 272 名（45%）报告比例高于 5%。报告比例为 5%或更低的外科医生将植入物体积的排名明显低于那些再手术率高于 5%的外科医生（2.93±1.71 对 2.55±1.53；p=0.004）。
乳房基底部直径和植入物体积是选择乳房增大植入物的两个最重要的考虑因素。对于那些将乳房基底部直径视为比植入物体积更重要的外科医生，报告的尺寸变化再手术率明显较低。
