Surgical and Neuropsychiatric Outcome of Reduction Mammoplasty and its impact on Quality of Life
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Objectives: To evaluate the surgical and neuropsychiatric outcome of reduction mammoplasty for women with bilateral macrosomia and its impact on patients quality of life (QoL). Patients & Methods: The study included 29 women with bilateral macrotnastia and assigned jar -e.tus.t ltgattrh."6&c.a..,aThttCS,Z, . W 11 INIANW ‘`... \\L Tholak and nwie to intra-rnarnmsry kid thstancts and the c\tent of heAst rw.h\st1;11 m supine position in relation to the level of the sternum. The QoL questionnaires and breast measurements were conducted preoperatively and 8 weeks post operative (PO). Reduction mammoplasty with superiomedial pedicle was performed and wounds were closed without drainage and weights of resected tissue were recorded. Ten-point visual analog scale (VAS) was used for assessment of patient's satisfaction by her breasts, preoperatively and postoperatively and for scar quality evaluation. Results: All surgeries passed smoothly without intraoperative complications with a mean operative time of 194±31.4 minutes and mean amount of blood loss of 361±73.6. Mean excised breast tissue weight was 1072.1±218.2; range: 745-1551 gm. Mean hospital stay was 2.8±0.7; range: 2-4 days. Five complications were recorded; 2 seroma and one hematoma and another 2 breasts developed partial areolar wound sloughing; all responded to conservative management. All PO breast measurements showed significant difference compared to preoperative measurements, and all patients were satisfied by the surgical outcome. Fifteen nipple-areola complexes (NAC) showed improved sensitivity, II NAC showed decreased sensitivity and 32 NAC showed no change and no NAC showed complete loss of sensation. Neurological evaluation showed significant PO improvement with a total improvement of QoL questionnaires; however, PO breast related symptoms questionnaire (BRSQ) showed the highest significant difference, while Roland and Morris disability questionnaire (RMDQ) was the least significant among studied questionnaires compared to preoperative scores. Conclusion: Bilateral reduction mammoplasty using superomedial pedicle is feasible and safe surgical procedure for women with macromastia. The applied technique provided significant reduction of breast dimensions with high patients' satisfaction and improved quality of life especially for breast and body contour with clearly obvious improvement of neuropsychiatric parameters.