Does Time Affect Patient Satisfaction and Health-related Quality of Life After Reduction Mammoplasty?

Wess A. Cohen, MD; Peter Homel, PhD; Nima P. Patel, MD

Disclosures

ePlasty. 2016;16 

In This Article

Abstract and Introduction

Abstract

Objective: A total of 62,611 patients with breast hypertrophy underwent breast reduction surgery in 2013 in the United States to improve their symptoms and health-related quality of life. While multiple studies utilizing various outcome instruments demonstrate the efficacy of reductive surgery, it is presently unknown how the postoperative course affects patient satisfaction and health-related quality of life as measured by the BREAST-Q. Our objective was to determine the temporal relationship of patient satisfaction and health-related quality of life after reduction mammoplasty.

Methods: Patients prospectively completed the BREAST-Q reduction mammoplasty module at 3 time points during their treatment: preoperatively, at less than 3 months postoperatively, and at more than 3 months (<12 months) postoperatively. A single surgeon (N.P.P.) performed all of the breast reduction procedures.

Results: Each time point contained 20 questionnaires. Mean preoperative BREAST-Q scores were significantly lower than scores at the less than 3-month postoperative time point for the scales Satisfaction With Breasts, Psychosocial Well-being, Sexual Well-being, and Physical Well-being (P < .001). There was no significant difference in BREAST-Q scores between the postoperative time points in these measures.

Conclusion: Breast reduction surgery offers a vast improvement in patients' satisfaction and health-related quality of life that is maintained throughout the postoperative period. These findings can assist surgeons in managing patient expectations after reduction mammoplasty and help improve the probability of obtaining prior authorization for insurance coverage.

Introduction

Breast reduction surgery is often undertaken because of gross dissatisfaction with the appearance of one's breasts, psychosocial embarrassment, or physical discomfort. In 2013, a total of 62,611 women underwent reduction mammoplasty in the United States.[1] While various outcomes instruments have been used to demonstrate the efficacy of reductive surgery in alleviating symptoms,[2–5] only 4 studies have utilized the BREAST-Q,[6–9] the current standard for procedure-specific patient-reported outcomes (PROs) in breast surgery.

Patient satisfaction and health-related quality of life (HR-QOL) are high at various postoperative time points after reduction mammoplasty.[6,8] In the only prospective study utilizing the BREAST-Q for reduction mammoplasty, Coriddi et al[7] found that breast reduction surgery significantly improved patients' satisfaction with the appearance of their breasts, as well as their psychosocial, physical, and sexual well-being, as early as 6 weeks postoperatively compared with preoperative levels. Other studies have demonstrated high levels of patient satisfaction and HR-QOL but were not prospective and did not investigate how time from surgery impacts PROs.[6,8]

Utilizing a prospective cohort, our objective was to investigate whether time from reduction mammoplasty impacts patient satisfaction and HR-QOL. We hypothesize that patient satisfaction and HR-QOL will change during the postoperative period. With this information, surgeons and their staff will be better able to assist patients in managing their postoperative expectations.

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