Patient satisfaction with vertical reduction mammaplasty: Part I

Patients with breast hypertrophy often experience a number of physical symptoms (including intertrigo, painful bra strap grooves, upper and lower back pain, shoulder pain, neck pain, arm pain, numbness or pain in the hands, breast pain, and headaches), as well as psychosocial difficulty. Although these preoperative symptoms have been well-documented in the literature, formal postoperative comparisons are rare.

The authors assessed the postoperative physical, psychosocial, and symptomatic changes following vertical reduction mammaplasty in 260 consecutive patients with various levels of breast hypertrophy.

From 2003-2009, questionnaires were administered preoperatively and postoperatively to 260 consecutive patients who had undergone superior pedicle vertical reduction mammaplasty and were not heavy smokers. The vast majority were primary procedures; 6% were revisions. Preoperative evaluation of each patient's suitability for mammaplasty included an assessment for skin quality and the presence of subdermal veins, areola size, quality of breast tissue, nipple position, presence of axillary rolls, and any asymmetry. The questionnaire administered was the 13-symptom severity scale designed by Kerrigan, which is scored on a 0-100 scale; a high score corresponds to fewer and less severe symptoms. The results were calculated by averaging the item scores and linearly transforming the average to the 0-100 scale.

The average amount excised from each breast was 850 g. Patients gave scores to each category both preoperatively and postoperatively. The largest improvements were seen with difficulty finding bras or clothes to fit, painful bra strap grooves, and difficulty running because of breast size. Results for this section were calculated by taking the difference between postoperative and preoperative values for a selected issue. Overall, combining all categories, the average preoperative value was 27.38 and the postoperative value was 96.615. A t-value of 46.0217 with a P-value < .0005 was obtained between the patients' preoperative answers and postoperative answers.

This study had the significant benefit of being performed exclusively by one plastic surgeon, which led to less operator-dependent variability. The patients in this series indicated high levels of satisfaction following vertical reduction mammaplasty. An added benefit was that the women had less scarring than with the inverted-T technique.