From the Divisions of Plastic and Reconstructive Surgery and Public Health Sciences, Department of Surgery, Washington University School of Medicine.
Plast Reconstr Surg. 2018 Aug;142(2):133e-144e. doi: 10.1097/PRS.0000000000004601.
Outcomes in primary breast augmentation depend on careful preoperative planning and clear communication between patient and surgeon. Three-dimensional imaging with computer simulation is an evolving technology with the potential to enhance the preoperative consultation for patients considering primary breast augmentation. The purpose of this study was to prospectively evaluate the impact of three-dimensional imaging with computer simulation on patient-reported and objective, mammometric outcomes in women undergoing primary breast augmentation.
One hundred patients were enrolled in a prospective trial with randomized and nonrandomized arms. The randomized arm was composed of a control group consisting of patients who underwent tissue-based planning without simulation (n = 13) and an intervention group consisting of patients who were simulated (n = 10). The remainder constituted the nonrandomized group who specifically sought preoperative simulation. Patient-reported outcomes (BREAST-Q) and mammometric data were recorded and compared preoperatively and 6 months postoperatively.
Over time, significantly more patients refused randomization and chose simulation (p = 0.03). Breast augmentation led to substantial improvements in satisfaction with breasts, sexual well-being, and outcome. Simulation, however, did not significantly impact patient-reported outcomes or mammometric parameters. No strong correlations were identified between patient-reported outcomes and mammometrics.
Patients are likely to use novel technology such as three-dimensional photography with computer simulation if they perceive it to enhance their understanding of their final outcome. These patients may seek out practices specifically offering such technology. Incorporation of simulation into the preoperative consultation, however, did not lead to clinically meaningful changes in patient-reported outcomes.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
原发性乳房隆乳术的效果取决于术前的精心规划和医患之间的明确沟通。三维成像和计算机模拟是一种不断发展的技术,有可能增强考虑原发性乳房隆乳术的患者的术前咨询。本研究的目的是前瞻性评估三维成像和计算机模拟对接受原发性乳房隆乳术的女性患者报告的和客观的乳房测量结果的影响。
100 名患者入组前瞻性试验,分为随机和非随机组。随机组由未进行模拟的组织基础规划的对照组(n=13)和进行模拟的干预组(n=10)组成。其余为专门寻求术前模拟的非随机组。记录并比较术前和术后 6 个月的患者报告结果(BREAST-Q)和乳房测量数据。
随着时间的推移,更多的患者拒绝随机选择并选择了模拟(p=0.03)。乳房隆乳术显著改善了对乳房的满意度、性幸福感和结果。然而,模拟并未显著影响患者报告的结果或乳房测量参数。患者报告的结果和乳房测量之间没有发现明显的相关性。
如果患者认为三维摄影和计算机模拟等新技术可以增强他们对最终结果的理解,他们可能会使用这些技术。这些患者可能会寻找专门提供此类技术的诊所。然而,将模拟纳入术前咨询并未导致患者报告的结果发生有临床意义的变化。
临床问题/证据水平:治疗性,II 级。