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[Long-term outcome analysis of subjective and objective parameters after breast reduction in 159 cases: Patients judge differently from plastic surgeons].

INTRODUCTION
This work assessed both subjective and objective postoperative parameters after breast reduction surgery and compared between patients and plastic surgeons.


PATIENTS AND METHODS
After an average postoperative observation period of 6.7 ± 2.7 (2 - 13) years, 159 out of 259 patients (61 %) were examined. The mean age at the time of surgery was 37 ± 14 (15 - 74) years. The postoperative anatomy of the breast and other anthropometric parameters were measured in cm with the patient in an upright position. The visual analogue scale (VAS) values for symmetry, size, shape, type of scar and overall satisfaction both from the patient's and from four plastic surgeons' perspectives were assessed and compared.


RESULTS
Patients rated the postoperative result significantly better than surgeons. Good subjective ratings by patients for shape, symmetry and sensitivity correlated with high scores for overall assessment. Shape had the strongest influence on overall satisfaction (regression coefficient 0.357; p < 0.001), followed by symmetry (regression coefficient 0.239; p < 0.001) and sensitivity (regression coefficient 0.109; p = 0.040) of the breast. The better the subjective rating for symmetry by the patient, the smaller the measured difference of the jugulum-mamillary distance between left and right (regression coefficient -0.773; p = 0.002) and the smaller the difference in height of the lowest part of the breast between left and right (regression coefficient -0.465; p = 0.035). There was no significant correlation between age, weight, height, BMI, resected weight of the breast, postoperative breast size or type of scar with overall satisfaction.


CONCLUSION
After breast reduction surgery, long-term outcome is rated significantly better by patients than by plastic surgeons. Good subjective ratings by patients for shape, symmetry and sensitivity correlated with high scores for overall assessment. Shape had the strongest influence on overall satisfaction, followed by symmetry and sensitivity of the breast. Postoperative size of the breast, resection weight, type of scar, age or BMI was not of significant influence. Symmetry was the only assessed subjective parameter of this study that could be objectified by postoperative measurements.