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
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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. |
