The Triple Plane, the Bra-Flap, and the Inverted Bra-Flap Modified Dual Plane Techniques for Breast Augmentation

Patient-Reported Satisfaction and Health-Related Quality of Life in Patients with Breast Augmentation: A Follow-Up of 6 Months

BACKGROUND

To evaluate the success of a breast augmentation, it is essential to measure outcomes from the patient perspective, because a successful aesthetic result is, in particular, determined by the patient. This study aimed to evaluate patient-reported satisfaction with their breasts, and psychosocial, physical, and sexual well-being in patients undergoing breast augmentation using validated questionnaires.

METHODS

This is a multicenter cohort study based on ongoing routinely collected data. Patient-reported satisfaction and health-related quality of life were assessed with the BREAST-Q augmentation module at intake and 6 months postoperatively.

RESULTS

A total of 1405 patients were included. Large changes in BREAST-Q scores (range, 0 to 100) between intake and 6 months postoperatively were seen in satisfaction with breasts (mean, effect size: +57, 3.8), psychosocial well-being (mean, effect size: +38, 2.1), physical well-being (mean, effect size: -14, -1.2), and sexual well-being (mean, effect size: +44, 2.4). Moreover, improvements in all four scales were not dependent on their intake scores, and all postoperative scores reached similar levels. A decreased physical well-being of the chest was measured after surgery. The satisfaction with breasts scale correlated moderately to strongly with the psychosocial and sexual well-being scale 6 months after surgery. Subgroup analysis based on patient characteristics found no differences in outcomes, except for body mass index.

CONCLUSIONS

Significant improvement in patient-reported satisfaction with breasts, psychosocial well-being, and sexual well-being can be seen 6 months after breast augmentation, despite a decline in physical well-being after treatment. Postoperative satisfaction levels did not depend on preoperative scores. These insights can contribute to improving preoperative communication between surgeon and patient regarding the expected outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, IV.

Endoscopic Primary Breast Augmentation With Loco-Regional Anesthesia: Preliminary Experience of 200 Consecutive Patients

Background

Breast augmentation with implants recorded over 1.6 billion procedures globally in 2022. To reduce surgical trauma and complications and facilitate a fast recovery, we employ an ultrasound-guided local-regional anesthesia technique, the creation of a partial submuscular implant pocket by direct endoscopic visualization and minimal skin access on the mammary fold.

Objectives

The aim in this study is to evaluate whether breast augmentation performed in endoscopy under local-regional anesthesia reduces postoperative recovery time, reduces complications, and increases patient satisfaction.

Methods

Patients provided their consent through a signed form. We set strict inclusion and exclusion criteria. We prospectively evaluated postoperative pain and recovery times, the rate of complications, and patient satisfaction at 12 months postsurgery.

Results

Between January 2021 and September 2022, 200 patients met the inclusion criteria. The average operation time was 54.2 min. Patients were discharged from the hospital within 2 to 3 h. Eighty-nine percent of patients expressed great satisfaction with the result. None of the patients experienced postsurgical complications.

Conclusions

In our initial study, we showed that endoscopic breast augmentation conducted under localized anesthesia is safe. It allows for quick recovery postsurgery and swift resumption of everyday activities. The overall complication risk is less than what has been reported in scientific studies for the classic dual-plane technique. Moreover, this approach yields excellent patient satisfaction. Additional prospective and randomized studies will be required to enhance the scientific validity of this technique. Moreover, a larger patient cohort will be essential to stratify the risks associated with varying prosthetic volumes.

Level of Evidence 4

Patient-Reported Outcomes after Subpectoral Breast Augmentation with Microtextured or Macrotextured Implants Using the BREAST-Q

Background  Breast augmentation with implants is the most commonly performed cosmetic plastic surgery in Brazil and worldwide. The aim of this study was to assess patient satisfaction and quality of life following subpectoral breast augmentation with either microtextured or macrotextured implants, using the BREAST-Q.

Methods  A prospective study was conducted with 40 women with hypomastia undergoing subpectoral breast augmentation. The patients were randomly allocated to two groups to receive either microtextured or macrotextured breast implants. All participants were assessed preoperatively (baseline) and after 2 and 4 months of surgery for quality of life and patient satisfaction with the surgical results, using the BREAST-Q augmentation module, a patient-reported outcome measure.

Results  The patients had a mean age of 28.9 ± 6.45 years. The microtextured ( n  = 20) and macrotextured ( n  = 20) groups were homogeneous for sex, age, education level, marital status, and number of children ( p  > 0.05). Both groups showed significant improvement in satisfaction with breasts ( p  < 0.001), psychosocial well-being ( p  < 0.001), and sexual well-being ( p  < 0.001) at the 2- and 4-month follow-up visits compared with baseline. The observed improvements were associated with high effect size values of 5.09, 3.44, and 3.90, respectively. In contrast, significant decreases from baseline in physical well-being scores ( p  = 0.001) were found 2 and 4 weeks after surgery in both groups.

Conclusion  Subpectoral breast augmentation with either microtextured or macrotextured breast implants improved satisfaction with breasts and quality of life in patients with hypomastia.