Plastic Surgery Research Council

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Effect of Surgical Complications on Health-Related Quality of Life Outcomes in Adolescents and Young Women Following Reduction Mammaplasty
Joseph M. Firriolo, MD, Laura C. Nuzzi, BA, Carolyn M. Pike, MPH, Brian I. Labow, MD.
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

PURPOSE: Although reduction mammaplasty is associated with improved health-related quality of life (HRQOL), surgical treatment for younger patients remains controversial. This study measures complications following reduction mammaplasty in adolescents and young women, and the impact of surgical complications on HRQOL outcomes.
METHODS: Clinical evaluations were performed and validated surveys were administered to skeletally mature patients undergoing reduction mammaplasty: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), Breast-Related Symptoms Questionnaire (BRSQ), and Eating-Attitudes Test-26 (EAT-26). Subjects completed surveys at baseline and postoperatively at 6 months, 1 year, 3 years, and 5 years.
RESULTS: Three-hundred and thirty subjects were included in analyses. The mean age of subjects at time of surgery was 17.9 years. Less than 1% of subjects experienced a major complication and roughly 20% experienced at least one minor complication, commonly: hypertrophic scarring, minor infection or wound dehiscence, or persistent altered breast sensation. Complication rates did not vary by BMI category, age, or amount of tissue resected. Patients demonstrated significant postoperative improvements in all SF-36 domains (physical functioning, role-physical, general health, bodily pain, vitality, social functioning, role-emotional, mental health), and on the RSES, BRSQ, and EAT-26. HRQOL outcomes largely did not vary by complication status.
CONCLUSION: Although major complications following reduction mammaplasty are rare in adolescents, minor complications are common. Complication rates in this sample did not vary by age, BMI, or resection mass. When complications occurred, patients experienced significant and similar HRQOL gains postoperatively as those patients without complications. Providers should be aware of the benefits reduction mammaplasty can provide younger macromastia patients, regardless of complication status.


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