Renaissance School of Medicine at Stony Brook University, Stony Brook.
Long Island Plastic Surgical Group PC, Garden City, NY.
Ann Plast Surg. 2023 Jun 1;90(6S Suppl 5):S659-S666. doi: 10.1097/SAP.0000000000003445. Epub 2023 Mar 4.
Despite the commonly recognized benefits and drawbacks of each surgical technique for reduction mammoplasty, data on the influence of each surgical approach on patient quality of life and satisfaction remains limited. Our study aims to evaluate the association between surgical factors and BREAST-Q scores for reduction mammoplasty patients.
A literature review through August 6, 2021, was conducted using the PubMed database to select publications that used the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. The BREAST-Q data were stratified by incision pattern and pedicle type.
We identified 14 articles that met selection criteria. Among 1816 patients, the mean age ranged from 15.8 to 55 years, mean body mass index ranged from 22.5 to 32.4 kg/m 2 , and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points ( P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points ( P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points ( P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points ( P < 0.0001). No significant correlations were observed when mean difference was modeled against complication rates or prevalence of superomedial pedicle use, inferior pedicle use, Wise pattern incision, or vertical pattern incision. Complication rates were not correlated with preoperative, postoperative, or mean change in BREAST-Q scores. A negative correlation was noted between the prevalence of superomedial pedicle use and postoperative physical well-being (Spearman rank correlation coefficient [SRCC], -0.66742; P < 0.05). The prevalence of Wise pattern incision was negatively correlated with postoperative sexual well-being (SRCC, -0.66233; P < 0.05) and physical well-being (SRCC, -0.69521; P < 0.05).
Although either preoperative or postoperative BREAST-Q scores may be individually influenced by pedicle or incision type, there was no statistically significant effect of surgical approach or complication rates on the average change of these scores, and overall satisfaction and well-being scores improved. This review suggests that any of the main surgical approaches to reduction mammoplasty provide equally substantial improvements in patient-reported satisfaction and quality of life, but more robust comparative studies would strengthen this area of research.
尽管缩乳术的每种手术技术都有其公认的优点和缺点，但关于每种手术方法对患者生活质量和满意度影响的数据仍然有限。我们的研究旨在评估手术因素与缩乳术患者 BREAST-Q 评分之间的关系。
通过 2021 年 8 月 6 日的文献综述，使用 PubMed 数据库选择使用 BREAST-Q 问卷评估缩乳术患者结局的出版物。排除研究乳房重建、乳房增大、肿瘤整形缩小或乳腺癌患者的研究。BREAST-Q 数据按切口模式和蒂型分层。
我们确定了 14 篇符合选择标准的文章。在 1816 名患者中，平均年龄为 15.8 至 55 岁，平均体重指数为 22.5 至 32.4kg/m 2 ，双侧平均切除重量为 323 至 1845.96g。总体并发症发生率为 19.9%。平均而言，乳房满意度提高了 52.1±0.9 分（P<0.0001），社会心理幸福感提高了 43.0±1.0 分（P<0.0001），性功能幸福感提高了 38.2±1.2 分（P<0.0001），身体幸福感提高了 27.9±0.8 分（P<0.0001）。当以平均差异为模型时，与并发症发生率或超级内侧蒂使用率、下蒂使用率、Wise 模式切口或垂直模式切口的流行率之间没有观察到显著相关性。并发症发生率与术前、术后或 BREAST-Q 评分的平均变化无关。超级内侧蒂使用率与术后身体舒适度呈负相关（Spearman 等级相关系数[SRCC]，-0.66742；P<0.05）。Wise 模式切口的流行率与术后性功能（SRCC，-0.66233；P<0.05）和身体舒适度（SRCC，-0.69521；P<0.05）呈负相关。
尽管术前或术后 BREAST-Q 评分可能会受到蒂型或切口类型的单独影响，但手术方法或并发症发生率对这些评分的平均变化没有统计学意义，总体满意度和舒适度评分有所提高。本综述表明，缩乳术的任何主要手术方法都能显著改善患者报告的满意度和生活质量，但更有力的比较研究将加强这一研究领域。
