CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(03): 352-359
DOI: 10.1055/s-0042-1748649
Breast/Trunk
Original Article

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

1   Graduate Program in Translational Surgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
,
2   Division of Plastic Surgery, Department of Surgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
,
3   São Paulo Hospital, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
,
2   Division of Plastic Surgery, Department of Surgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
,
2   Division of Plastic Surgery, Department of Surgery, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
› Author Affiliations
Funding None.

Abstract

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.

Author Contributions

Conceptualization: A.T.L., M.S.N., V.C.L.R, D.F.V., L.M.F. Data curation: A.T.L., M.S.N., V.C.L.R., D.F.V. Project administration: M.S.N., D.F.V., L.M.F. Visualization: A.T.L., M.S.N., V.C.L.R., D.F.V., L.M.F. Writing - original draft: A.T.L., M.S.N., V.C.L.R., D.F.V. Writing - review and editing: A.T.L., M.S.N., V.C.L.R., D.F.V., L.M.F. Approval of final manuscript: all authors.


Ethical Approval

All procedures involving human participants were approved by the Institutional Review Board (IRB No. 1344/2015) and performed in accordance with the ethical standards of the Resolution 466/12 of the Brazilian National Health Council (CNS) on research involving human beings and with the 1964 Helsinki Declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors. All participants gave their informed consent in writing prior to inclusion in the study for use of clinical data for scientific purposes and publication.


Patient Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Article published online:
27 May 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 International Society of Aesthetic Plastic Surgery (ISAPS).. ISAPS International Survey on Aesthetic/Cosmetic Procedures performed in 2019 [Internet]. ISAPS;. 2020 . Accessed June 10, 2021 at: https://www.isaps.org/wp-content/uploads/2020/12/Global-Survey-2019.pdf
  • 2 Sociedade Brasileira de Cirurgia Plástica (SBCP).. Censo 2018: Análise comparativa das pesquisas 2014, 2016 e 2018 [2018 Census: Comparative analysis of surveys 2014, 2016 and 2018] [Internet]. São Paulo Brasil: SBPC; 2019 . Accessed June 2, 2021 at: http://www2.cirurgiaplastica.org.br/wp-content/uploads/2019/08/Apresentac%CC%A7a%CC%83o-Censo-2018_V3.pdf
  • 3 McCarthy CM, Cano SJ, Klassen AF. et al. The magnitude of effect of cosmetic breast augmentation on patient satisfaction and health-related quality of life. Plast Reconstr Surg 2012; 130 (01) 218-223
  • 4 Kalaaji A, Dreyer S, Brinkmann J, Maric I, Nordahl C, Olafsen K. Quality of life after breast enlargement with implants versus augmentation mastopexy: a comparative study. Aesthet Surg J 2018; 38 (12) 1304-1315
  • 5 Maxwell GP, Scheflan M, Spear S, Nava MB, Hedén P. Benefits and limitation of macrotextured breast implants and consensus recommendations for optimizing their effectiveness. Aesthet Surg J 2014; 34 (06) 876-881
  • 6 Derby BM, Codner MA. Textured silicone breast implant use in primary augmentation: core data update and review. Plast Reconstr Surg 2015; 135 (01) 113-124
  • 7 Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 2009; 124 (02) 345-353
  • 8 Alderman AK, Bauer J, Fardo D, Abrahamse P, Pusic A. Understanding the effect of breast augmentation on quality of life: prospective analysis using the BREAST-Q. Plast Reconstr Surg 2014; 133 (04) 787-795
  • 9 Alderman A, Pusic A, Murphy DK. Prospective analysis of primary breast augmentation on body image using the BREAST-Q: results from a nationwide study. Plast Reconstr Surg 2016; 137 (06) 954e-960e
  • 10 Brault N, Stivala A, Guillier D. et al. Correction of tuberous breast deformity: a retrospective study comparing lipofilling versus breast implant augmentation. J Plast Reconstr Aesthet Surg 2017; 70 (05) 585-595
  • 11 Deschler A, Stroumza N, Pessis R, Azuelos A, Atlan M. Primary breast augmentation with autologous fat grafting alone: evaluation of patient satisfaction using the BREAST-Q. Aesthet Surg J 2020; 40 (11) 1196-1204
  • 12 Pusic AL, Reavey PL, Klassen AF, Scott A, McCarthy C, Cano SJ. Measuring patient outcomes in breast augmentation: introducing the BREAST-Q augmentation module. Clin Plast Surg 2009; 36 (01) 23-32
  • 13 Sbalchiero JC, Cordanto-Nopoulos FR, Silva CHD. et al. Breast-Q questionnaire, translation process to Portuguese language and their application on breast cancer patients. Rev Bras Cir Plást 2013; 28: 549-552
  • 14 Cano SJ, Klassen AF, Scott AM, Pusic AL. A closer look at the BREAST-Q(©). Clin Plast Surg 2013; 40 (02) 287-296
  • 15 Cohen WA, Mundy LR, Ballard TN. et al. The BREAST-Q in surgical research: a review of the literature 2009-2015. J Plast Reconstr Aesthet Surg 2016; 69 (02) 149-162
  • 16 Sacchini V, Luini A, Tana S. et al. Quantitative and qualitative cosmetic evaluation after conservative treatment for breast cancer. Eur J Cancer 1991; 27 (11) 1395-1400
  • 17 Tebbetts JB, Adams WP. Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 2006; 118 (7, Suppl): 35S-45S
  • 18 Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale. NJ: Erlbaum; 1988
  • 19 Coriddi M, Angelos T, Nadeau M, Bennett M, Taylor A. Analysis of satisfaction and well-being in the short follow-up from breast augmentation using the BREAST-Q, a validated survey instrument. Aesthet Surg J 2013; 33 (02) 245-251
  • 20 Diaz JF. Review of 494 consecutive breast augmentation patients: system to improve patient outcomes and satisfaction. Plast Reconstr Surg Glob Open 2017; 5 (10) e1526
  • 21 Gryskiewicz J, LeDuc R. Transaxillary nonendoscopic subpectoral augmentation mammaplasty: a 10-year experience with gel vs saline in 2000 patients with long-term patient satisfaction measured by the BREAST-Q. Aesthet Surg J 2014; 34 (05) 696-713
  • 22 Randquist C, Por YC, Yeow V, Maglambayan J, Simonyi S. Breast augmentation surgery using an inframammary fold incision in Southeast Asian women: patient-reported outcomes. Arch Plast Surg 2018; 45 (04) 367-374
  • 23 Abla LEF, Sabino Neto M, Garcia EB. et al. Quality of life and self-esteem outcomes following augmentation mammaplasty. Rev Bras Mastologia 2010; 20: 22-26
  • 24 Neto MS, Abla LE, Lemos AL. et al. The impact of surgical treatment on the self-esteem of patients with breast hypertrophy, hypomastia, or breast asymmetry. Aesthetic Plast Surg 2012; 36 (01) 223-225
  • 25 Xu H, Li W, Chen Y, Zhu Y, Hao L. New design for axillary dual-plane endoscopic breast augmentation for Asians: the feasibility of two types of dual-plane implant pockets in 70 patients as measured by the BREAST-Q. Aesthetic Plast Surg 2016; 40 (01) 79-88
  • 26 Overschmidt B, Qureshi AA, Parikh RP, Yan Y, Tenenbaum MM, Myckatyn TM. A prospective evaluation of three-dimensional image simulation: patient-reported outcomes and mammometrics in primary breast augmentation. Plast Reconstr Surg 2018; 142 (02) 133e-144e
  • 27 Bracaglia R, Servillo M, Fortunato R, Gentileschi S. The triple-plane BRA-flap and inverted BRA-flap modified dual-plane techniques for breast augmentation. Aesthet Surg J 2020; 40 (04) NP141-NP151