The Underappreciated Benefit Of Breast Reduction: Quality Of Life Improvement After Reduction Mammoplasty
Arturo J. Rios-Diaz, MD, Jessica R. Cunning, BS, MBA, Charles A. Messa, IV, BS, Roten Kimia, BS, Louis-Xavier Barrette, BS, Robyn B. Broach, PhD, Paris D. Butler, MD, MPH, John P. Fischer, MD, MPH.
University of Pennsylvania, Philadelphia, PA, USA.
Purpose: Health-related quality of life (QoL) improvement coinciding with breast reduction (BR) for patients suffering with macromastia has yet to be defined. We aimed to quantify the benefit of BR by describing the magnitude of change in patient-reported QoL for those who underwent this procedure.
Methods: Patients who underwent BR for macromastia between 2016-2019 were prospectively surveyed using the Breast-Q at their pre- and postoperative visits. Patient characteristics, clinical outcomes, and QoL scores (0-100) were analyzed using descriptive statistics and paired Wilcoxon signed-rank tests.
Results: Out of 163 undergoing BR, 80 (49%) completed both pre- and postoperative Breast-Q surveys. The median age was 39 years old (IQR 27-51); the majority were Black (56.3%), non-obese (BMI<30: 56%), covered by insurance (92.5%), had grade-III ptosis (66.7%), cup-size >DD (72.3%), and experienced brassier notching (96.3%) and/or rash (76.3%). Scores significantly improved for the breast satisfaction domain (pre: 23 [IQR 12-29], post: 84 [72-100]), as well as with psychosocial (pre: 37 [21-46] vs. post: 100 [77-100]), sexual (pre: 35 [21-40], post: 100 [67-100]), and physical well-being domains (pre: 42 [31-53], post 83 [71-92]; all p<0.01). Postoperative breast satisfaction was negatively impacted by surgical site infections (SSI: 53 [53-53], no SSI: 84 [72-100], p=0.027).
Conclusions: The benefit of BR on QoL should not be underrated as it spreads across satisfaction with breasts in addition to psychosocial, sexual and physical well-being. Efforts to ensure this benefit should be targeted towards SSI prevention as these negatively impact QoL.
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