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Reduction Mammaplasty: An Assessment Of Risk Factors For Post Operative Complications And Patient Satisfaction

4922 words - 20 pages

ABSTRACTA retrospective study was designed to determine whether patient specific factors - age, smoking and obesity (Body Mass Index) and intra-operative factors, such as weight of tissue removed and duration of operation, influence the complication rates in, patients after reduction mammaplasty. Additionally, it evaluates the long-term results and patient satisfaction after breast reduction. The data was assimilated through a combination of reviewing medical records and telephone questionnaires. We reviewed 67 patients who had bilateral breast reduction at the Queen Elizabeth Hospital (Adelaide) between 1993-98. Mean age of the patient population at the time of surgery was 38.6 years. Mean preoperative weight was 79.5 kg and mean BMI was 30.4 kg/m". The most common presenting complaints were back, neck and shoulder pain, shoulder grooving and skin rashes. 39% of patients also had cosmetic concerns. The inferior pedicle technique was performed in 94% of patients and mean duration of surgery was 135 min. An average of 740g of tissue was resected per breast. The overall complication rate was 79%. The patient's satisfaction rate with the surgery was 93% and the same percentage of patients reported either an improvement of symptoms or complete resolution. The results of this study shows that increased BMI and preoperative body weight are associated with a significant increase in the complication rate (p= 0.006 and p= 0.018). However, the symptom relief in these patients occurred independently of weight and BMI. The study also shows that smoking increases risk of having late complications by 1.85 times compared with non-smokers (p=0.02). Our results did not find a correlation between age and complication rate (p=0.94). In addition, we found that weight of tissue removed and duration of operation do not influence the post-operative complication rates. Our findings also show that there is no correlation between the amount of tissue removed and diminished sensation of the nipple-areola complex.INTRODUCTIONThe first breast reduction surgery reported in surgical literature probably dates from 1669, performed by Dr. William Durston in England. ¹ Nowadays, reduction mammaplasty is one of the most commonly performed operations in plastic surgery. According to some studies in the USA about 40,000 women undergo breast reduction surgery each year " and in England there is a rate of 10 patients per 100,000 females. "The large breasts have been considered throughout history as a symbol of women's fertility and sexuality. However, large and pendulous breasts can cause a complex of symptoms that can greatly impair the quality of life of these women.There are many reasons women seek surgical treatment for large breasts. 4,5,6,7The majority of patients are motivated by physical signs and symptoms such as back, neck and shoulder pain and/or painful shoulder grooves and poor posture rather than for cosmetic reasons. Also, the extreme embarrassment and social...

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