Fabi Adriano, Gütermann Julian C, Kaiser Benedict, Müller Vanessa, Halbeisen Florian S, Rueter Florian, Engels Patricia E, Kalbermatten Daniel F, Haug Martin D, Schaefer Dirk J, di Summa Pietro G, Kappos Elisabeth A
From the Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.
Plast Reconstr Surg Glob Open. 2025 Apr 18;13(4):e6709. doi: 10.1097/GOX.0000000000006709. eCollection 2025 Apr.
Breast reduction surgery has been recognized for its potential to improve quality of life in patients with macromastia or after unilateral oncological treatment. However, comparative analysis of different surgical techniques remains sparse. Patient-reported outcome measures have emerged as indispensable tools in assessing patient satisfaction and postoperative outcomes. Driven by the hypothesis of substantial differences between self-reported patient outcomes and professional assessments, this study aimed to compare different technical approaches, integrating both the patients' and plastic surgeons' perspectives.
A 10-year retrospective single-center cohort study was conducted to compare patient- and surgeon-reported outcomes using pre- and postoperative BREAST-Q questionnaires and aesthetic self-assessments. Outcomes and postoperative complication rates of different technical approaches were analyzed using photographic documentation.
A total of 170 patients met the inclusion criteria, of which 92 agreed to further photographic documentation for aesthetic evaluation. The median follow-up duration was 4.9 years. BREAST-Q scores significantly improved across all surgical techniques, with comparable scores in both oncoplastic and nononcoplastic patients. Notably, patients reported greater satisfaction with the postoperative aesthetic outcomes than surgeons. Multivariable analysis confirmed body mass index as a significant risk factor for postoperative complications.
Breast reduction surgery improves both aesthetic outcomes and long-term quality of life, regardless of surgical technique or the use of oncoplastic methods. The discrepancy between patient and surgeon satisfaction highlights the need for a patient-centered approach, such as incorporating patient-reported outcome measures to evaluate postoperative results.
乳房缩小术已被认可具有改善巨乳症患者或单侧肿瘤治疗后患者生活质量的潜力。然而，不同手术技术的比较分析仍然很少。患者报告的结局指标已成为评估患者满意度和术后结局不可或缺的工具。受患者自我报告结局与专业评估之间存在显著差异这一假设的驱动，本研究旨在整合患者和整形外科医生的观点，比较不同的技术方法。
进行了一项为期10年的回顾性单中心队列研究，使用术前和术后的BREAST-Q问卷以及美学自我评估来比较患者和外科医生报告的结局。使用照片记录分析不同技术方法的结局和术后并发症发生率。
共有170例患者符合纳入标准，其中92例同意进一步进行照片记录以进行美学评估。中位随访时间为4.9年。所有手术技术的BREAST-Q评分均显著改善，肿瘤整形患者和非肿瘤整形患者的评分相当。值得注意的是，患者对术后美学结局的满意度高于外科医生。多变量分析证实体重指数是术后并发症的一个重要危险因素。
乳房缩小术可改善美学结局和长期生活质量，无论手术技术如何或是否使用肿瘤整形方法。患者和外科医生满意度之间的差异凸显了以患者为中心的方法的必要性，例如纳入患者报告的结局指标来评估术后结果。
