Patient-Surgeon Satisfaction Discrepancy following Breast Reduction Surgery: A 10-year Analysis of Aesthetic Outcomes and Quality of Life

Abstract

Background: Breast reduction surgery has been recognized for its potential to improve quality of life in patients with macromastia or after unilateral oncological treatment. However, comparative analysis of different surgical techniques remains sparse. Patient-reported outcome measures have emerged as indispensable tools in assessing patient satisfaction and postoperative outcomes. Driven by the hypothesis of substantial differences between self-reported patient outcomes and professional assessments, this study aimed to compare different technical approaches, integrating both the patients' and plastic surgeons' perspectives. Methods: A 10-year retrospective single-center cohort study was conducted to compare patient- and surgeon-reported outcomes using pre- and postoperative BREAST-Q questionnaires and aesthetic self-assessments. Outcomes and postoperative complication rates of different technical approaches were analyzed using photographic documentation. Results: A total of 170 patients met the inclusion criteria, of which 92 agreed to further photographic documentation for aesthetic evaluation. The median follow-up duration was 4.9 years. BREAST-Q scores significantly improved across all surgical techniques, with comparable scores in both oncoplastic and nononcoplastic patients. Notably, patients reported greater satisfaction with the postoperative aesthetic outcomes than surgeons. Multivariable analysis confirmed body mass index as a significant risk factor for postoperative complications. Conclusions: Breast reduction surgery improves both aesthetic outcomes and long-term quality of life, regardless of surgical technique or the use of oncoplastic methods. The discrepancy between patient and surgeon satisfaction highlights the need for a patient-centered approach, such as incorporating patient-reported outcome measures to evaluate postoperative results.