Department of Plastic and Reconstructive Surgery, IFO - "Regina Elena" National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
Plastic Surgery, Medicinaplasticaroma Center, Via Arno 47, 00198, Rome, Italy.
Aesthetic Plast Surg. 2019 Dec;43(6):1439-1450. doi: 10.1007/s00266-019-01489-0. Epub 2019 Sep 4.
In the literature, several classifications of breast asymmetries and treatment protocols have been proposed over time, which are mainly based on etiological or morphological characteristics of the deformity. The aim of this study was to present our new classification, based on patient's self-consciousness of breast asymmetry, a simple and reliable treatment algorithm is also presented.
The case series included 343 patients treated between January 2006 and January 2015. Only patients presenting with developmental breast asymmetries were included in the study. All patients underwent prior classification in three groups based on the patient's degree of awareness of their asymmetry. A specific treatment algorithm was associated with each group according to breast size, grade of ptosis, and patient's desire. At the 48-month follow-up appointment, patients completed an anonymous questionnaire that addressed satisfaction with breast shape, size, and symmetry, scar appearance, body perception, self-esteem, perceived attractiveness, intimate life, and overall feelings about their breasts.
Mean patient age was 24.6 years (range 18-57 years). Mean follow-up was 54.4 months (6 months to 9 years). At the 48-month follow-up, 66.7% of the patients completed a visual analog scale (VAS) satisfaction questionnaire. An overall satisfaction rate of 77.0% was reported, and a statistically significant difference in the distribution of the overall satisfaction between groups was found. No patient expressed complete dissatisfaction.
The proposed classification and the surgical algorithm is a simple, applicable, and reliable method to assess and treat breast asymmetries with a high satisfaction rate as confirmed from our results.
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在文献中，随着时间的推移，已经提出了几种乳房不对称的分类和治疗方案，这些方案主要基于畸形的病因或形态学特征。本研究的目的是提出我们新的分类，基于患者对乳房不对称的自我意识，同时提出一种简单可靠的治疗算法。
该病例系列包括 2006 年 1 月至 2015 年 1 月期间治疗的 343 例患者。本研究仅纳入存在发育性乳房不对称的患者。所有患者均接受过术前分类，根据患者对自身不对称程度的意识，将其分为三组。根据乳房大小、下垂程度和患者意愿，为每组患者制定了特定的治疗方案。在 48 个月的随访中，患者完成了一份匿名问卷，内容涉及对乳房形状、大小和对称性、疤痕外观、身体感知、自尊、吸引力感知、性生活以及对乳房整体感觉的满意度。
患者平均年龄为 24.6 岁（18-57 岁）。平均随访时间为 54.4 个月（6 个月至 9 年）。在 48 个月的随访中，66.7%的患者完成了视觉模拟评分（VAS）满意度问卷。报告的总体满意度为 77.0%，并且发现组间总体满意度的分布存在统计学显著差异。没有患者表示完全不满意。
所提出的分类和手术算法是一种简单、适用且可靠的方法，可用于评估和治疗乳房不对称，并且从我们的结果来看，其满意度较高。
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