Effect of Surgical Complications on Health-Related Quality of Life Outcomes in Adolescents and Young Women Following Reduction Mammaplasty
Laura C. Nuzzi, BA, Joseph M. Firriolo, MD, Carolyn M. Pike, MPH, Brian I. Labow, MD.
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
BACKGROUND: Although reduction mammaplasty is associated with improved health-related quality of life (HRQoL), surgical treatment for younger patients remains controversial. This study measures complications following reduction mammaplasty in adolescents and young women, and the impact of surgical complications on HRQoL outcomes.
METHODS: Clinical evaluations were performed and the following validated surveys were administered to skeletally mature patients undergoing reduction mammaplasty, aged 12-21 years: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), Breast-Related Symptoms Questionnaire (BRSQ), and Eating-Attitudes Test-26 (EAT-26). Subjects completed surveys at baseline and postoperatively at 6 months, 1 year, 3 years, 5 years, and 7 years.
RESULTS: A total of 512 subjects were included (mean age: 17.8 years). Less than one-third of subjects experienced a complication, most commonly: hypertrophic scarring, persistent altered breast or nipple sensation, keloid formation, and T-junction wounds. Complication rates did not vary by body mass index (BMI) category, age, or the amount of tissue resected. Patients demonstrated significant postoperative improvements in all eight SF-36 domains (physical functioning, role-physical, general health, bodily pain, vitality, social functioning, role-emotional, and mental health), and on the RSES, BRSQ, and EAT-26. HRQoL outcomes largely did not vary by complication status.
CONCLUSIONS: Although major complications following reduction mammaplasty are rare in adolescents, minor complications are common. Complication rates in this sample did not vary by age, BMI, or resection mass. Patients who experienced at least one postoperative complication demonstrated significant postoperative HRQoL gains, comparable to patients without complications. Providers should be aware of the benefits reduction mammaplasty can provide younger patients with macromastia, regardless of complication status.
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