Leawood, Kan. From the Swanson Center.
Plast Reconstr Surg. 2013 May;131(5):1158-1166. doi: 10.1097/PRS.0b013e318287a0e1.
Despite the popularity of breast augmentation, limited information is available evaluating this procedure from the patient's perspective. No existing studies assess patient-reported data prospectively in a large number of consecutive patients with a high inclusion rate, as required by evidence-based medicine. This prospective outcome study was undertaken to obtain this information.
Over a 5-year period, 281 consecutive women underwent breast augmentation performed by the author. In-person interviews were conducted at least 1 month after surgery among 225 women (response rate, 80.1 percent). All implants, predominantly saline-filled, were placed submuscularly using primarily inframammary incisions. Questions were asked in six categories: patient data, indications, recovery, results, complications, and psychological effects. A follow-up study evaluated subjective nipple numbness.
The mean implant volume was approximately 390 cc. The mean pain rating was 5.9 on a scale of 1 to 10. The mean time off work was 6.6 days. The mean result rating was 9.3 on a scale of 1 to 10. Expectations were met or exceeded in 98.1 percent of patients. Satisfactory size was achieved in 85.5 percent of patients and satisfactory firmness was achieved in 75.7 percent. The reported complication rate was 10.2 percent. Breast self-consciousness decreased from 86.2 percent to 12.6 percent (p < 0.001). The result rating correlated with a low rate of complications (p < 0.001).
Breast augmentation improves self-esteem (91.1 percent) and quality of life (64.3 percent). Nipple numbness is common (39.1 percent), but persistent numbness is unusual (2.3 percent). Almost all patients (98.7 percent) would repeat the surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
尽管隆胸术广受欢迎，但从患者角度评估该手术的信息有限。没有现有的研究从循证医学的角度前瞻性地评估大量连续患者的患者报告数据，且纳入率高。因此，进行了这项前瞻性结果研究以获取该信息。
在 5 年期间，作者对 281 例连续女性进行了隆胸术。在手术后至少 1 个月，对 225 例女性（应答率为 80.1%）进行了面对面访谈。所有植入物主要为盐水填充，均通过主要乳晕下切口置于胸肌下。询问了六个类别的问题：患者数据、适应症、恢复、结果、并发症和心理影响。后续研究评估了主观乳头麻木。
平均植入物体积约为 390cc。平均疼痛评分在 1 到 10 的量表上为 5.9。平均休假时间为 6.6 天。平均结果评分在 1 到 10 的量表上为 9.3。98.1%的患者的期望得到满足或超过。85.5%的患者达到了满意的大小，75.7%的患者达到了满意的硬度。报告的并发症发生率为 10.2%。乳房自觉意识从 86.2%下降到 12.6%（p < 0.001）。结果评分与低并发症发生率相关（p < 0.001）。
隆胸术可提高自尊（91.1%）和生活质量（64.3%）。乳头麻木很常见（39.1%），但持续麻木不常见（2.3%）。几乎所有患者（98.7%）都会再次接受手术。
临床问题/证据水平：治疗性，IV。
