Patient satisfaction in breast reduction using the medal pedicle technique versus the inferior pedicle technique

Mokwatlo, Peter Noko
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Background: Breast reduction surgery is an accepted and commonly performed procedure for addressing gigantomastia for cosmetic and functional purposes. It has been proven to have a high rate of patient satisfaction. It is a functional operation, improving quality of life in symptomatic patients. Aims: This study evaluated patients’ satisfaction in subjects who had undergone breast reduction surgery between June 2017 and June 2018 at Chris Hani Baragwanath Academic Hospital (CHBAH), Helen Joseph Academic Hospital (HJAH) and Netcare Rand Clinic, using the medial pedicle technique versus the inferior pedicle technique. Methods: Patient satisfaction was evaluated by assessing the following domains, satisfaction with breasts, satisfaction with nipples, satisfaction with outcome, psychosocial well-being, sexual well-being, physical well-being. The BREAST-Q questionnaire is a measuring tool employed to evaluate patient satisfaction secondary to breast reduction that meets international and federal standards. A total of 30 patients completed the BREAST-Q questionnaire in the clinics as they came for their follow-ups post-surgery. Fifteen participants had undergone breast reduction through the medial pedicle technique whilst the other 15 had had the procedure performed using the inferior pedicle technique. Results: The pedicles used were medial (n =15) and inferior (n =15). The findings were; breast satisfaction: medial pedicle technique 68.9 ± 17.6, inferior pedicle technique 69.6 ± 18.7 with a p-value of 0.926. Physical wellbeing: medial pedicle technique 62.7 ± 19.6, inferior pedicle technique 84.2 ± 14.2 with a p-value of 0.002. The two techniques performed equally on average and in all the domains except in the physical wellbeing domain where the inferior pedicle technique had a statistically significant superiority to the medial pedicle technique. Conclusions: The use of different techniques in breast reduction will continue. Through the use of tools like the BREAST-Q questionnaire in patient related outcome measurements, we will gain a window into the patients’ feeling about the different techniques and in the process learn or change to techniques that offer better patient satisfaction. The resected breast tissue should have been weighed at the time of operation. Symptom relief is based on the volume of tissue resected.
A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in Plastic and Reconstructive Surgery. Johannesburg, 2018