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Factors influencing aesthetic outcomes and quality of life after oncoplastic reduction
Isis Scomacao, Valerie Carbajal, Johnathan Wyrick, Eliana Duraes, Andi Cummins, Humzah Quereshy, Cagri Cakmakoglu, Graham Schwarz
Cleveland Clinic
2019-02-15
Presenter: Isis Scomacao
Affidavit:
Steven Bernard
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: The purpose of this retrospective study was to analyze factors influencing patient satisfaction and aesthetic outcomes after oncoplastic reduction.
Methods: The medical records of patients who underwent oncoplastic reduction from 2011-2018 were reviewed. Patient demographics, previous surgeries, smoking status, radiotherapy history, surgical information and post-operative complications (delayed wound healing, dehiscence, mastectomy flap necrosis, and infection) were collected. Aesthetic evaluations were performed by four independent members of our research team (blinded to treatment group) post-operatively - grading multiple parameters of each breast on a scale of 1-5, including symmetry, shape, overall appearance. Patient satisfaction was evaluated through Breast-Q (breast conserving therapy modules). Bivariate and multivariate analyses were completed for both surgical and aesthetic outcomes.
Results: A total of 255 patients (240 breasts) were evaluated. Ninety two (39.48%) patients had post-operative photos evaluated and 40(17.16%) answered the Breast-Q. There was no significant difference in aesthetic evaluation scores or Breast-Q scores when stratifying patients by the presence or absence of post-op complications or radiation therapy, or when looking at different pedicle techniques. Patients who received radiation therapy were less likely to suffer from post-op seroma complications (OR 0.31; p= 0.039) in bivariate analysis. Breast aesthetics were not significantly influenced by age, BMI, race, post-operative complications, revision surgeries or history of radiation therapy.
Conclusion: Pedicle technique, exposure to radiation, comorbid conditions, post-operative complications did not significantly influence aesthetic outcomes or post-operative patient satisfaction.
