Different scar techniques make for satisfactory breast reductions
MedWire News: Patient satisfaction with either the vertical scar or inverted-T scar techniques for reduction mammoplasty remains high at least 10 years after surgery, research shows.
Aesthetic outcomes with either technique were also satisfactory in the long term, despite high rates of bottoming out and/or breast ptosis.
According to the researchers, these findings "clearly demonstrate that the initial outcome of [either technique] remains stable on the long term," an important conclusion given the scarcity of studies evaluating long-term outcomes of breast reduction surgery.
The retrospective study, published in the Journal of Plastic, Reconstructive & Aesthetic Surgery, compared the initial and long-term outcomes of reduction mammoplasty in patients who had undergone surgery in the Medical Center of Leeuwarden, the Netherlands, between 1997 and 2000.
Ten years after surgery, Berend van de Lei and colleagues carried out a subjective and objective evaluation on a final cohort of 69 out of 281 patients who had received surgery during this period and were available for follow up.
Patients gave a median general appreciation score of 8 (on a scale of 1-10, with 10 being very satisfied). There was no significant difference in patient satisfaction between the groups.
Of the 46 patients suitable for objective Strasser-grade evaluation by plastic surgeons, 37%, 46%, and 17% patients had "good," "mediocre," and "poor" results, respectively, at 3 months. At 10 years, the respective results were 80%, 13%, and 7%.
Strasser scores were significantly better at long-term follow up than at 3-months follow up.
At 3 months, the researchers found a higher initial incidence of bottoming out (or pseudoptosis) in the vertical scar group (one in two patients) than in the inverted-T scar group (one in 10 patients). However, after 10 years, bottoming out was observed in 20% of patients in the vertical scar group, and 50% of patients in the inverted-T scar group.
According to the researchers, this long-term problem of bottoming out warrants further research to find better techniques.
The only other factor that led to patient dissatisfaction was the occurrence of complications, in 11 (16%) of the 69 patients, during the initial 3-month period after surgery.
By Christopher Walsh