Experiencias antes y después de la mamoplastia de reducción en pacientes con macromastia / Experiences before and after reduction mammoplasty in patients with macromastia

Introducción: la hipertrofia mamaria o macromastia es un desarrollo excesivo y desproporcionado de tejido mamario, que suele ir asociada con síntomas físicos y psíquicos que alteran la calidad de vida y pueden ser en ocasiones tremendamente incapacitantes. Prácticamente la única opción terapéutica para estas pacientes es la mamoplastia de reducción, procedimiento quirúrgico que ha demostrado ser muy eficaz para reducir los síntomas. Objetivo: describir y analizar los resultados de la intervención desde el punto de vista de las propias pacientes con macromastia antes y después de la reducción mamaria, a través de los comentarios expresados por ellas mismas. Material y métodos: Estudio prospectivo. Análisis de las características de las pacientes, valoración del cambio en la salud experimentado tras la intervención y las experiencias subjetivas de las mujeres relativas a su macromastia antes y después de la intervención. Resultados: Un total de 121 mujeres intervenidas de macromastia con una edad media de 40,71 años participaron en el estudio. Las pacientes experimentaron un cambio positivo en su estado de salud tras la intervención (p < 0,001). La mayoría de los problemas verbalizados hacían referencia a la dificultad en el vestir y en realizar actividad física, así como la gran mejoría experimentada tras la intervención Conclusión: las experiencias compartidas por las mujeres con macromastia tras la reducción mamaria evidencian una significativa mejoría tanto en su percepción de la salud como en su vida cotidiana, incluyendo el encontrar una ropa adecuada a su gusto y necesidades de actividad física. (AU)

Introduction: Mammary hypertrophy or macromastia is an excessive and disproportionate development of breast tissue, which is usually associated with physical and mental symptoms that alter the quality of life and can sometimes be tremendously disabling. Practically the only therapeutic option for these patients is a reduction mammoplasty, a surgical procedure that has proven to be very effective in reducing symptoms. Objective: To describe and analyze the outcomes of the intervention from the point of view of the patients themselves through the comments expressed by patients with macromastia before and after breast reduction. Material and methods: Prospective study. Analysis of the characteristics of the patients, assessment of the health change experienced after the intervention, and the subjective experiences of the women regarding their macromastia before and after the intervention. Results: A total of 121 women operated on for macromastia with a mean age of 40.71 years participated in the study. The patients experienced a positive change in their health status after the intervention (p < 0.001). Most of the verbalized problems referred to the difficulty in dressing and carrying out physical activity, as well as the great improvement experienced after the intervention. Conclusion: The experiences shared by women with macromastia after breast reduction surgery demonstrate a significant improvement not only in their perception of health but also in their daily life, including finding clothing that is suitable for their preferences and physical activity needs. (AU)

Impacto de la reducción mamaria en la salud autopercibida en pacientes con macromastia / Impact of breast reduction in self-perceived health by patients with macromastia

Objetivo: valorar la evolución a corto plazo de parámetros psicosociales y clínicos de mujeres con macromastia tras la reducción mamaria. Metodología: estudio observacional prospectivo en mujeres con macromastia tras la reducción mamaria atendidas en el Hospital Clínico Universitario Lozano Bless de Zaragoza. Se recogieron datos sociodemográficos, clínicos, parámetros psicosociales y de calidad de vida. La información se recogió en dos momentos, antes de la intervención (momento basal) y al mes de la misma, a través de varios cuestionarios: identificación de síntomas específicos de la macromastia, calidad de vida mediante cuestionario de salud SF-36, estados de ansiedad y de depresión mediante el instrumento HADS, y la subescala de insatisfacción corporal del EDI-2. Para estimar si hubo cambios en el estado de las pacientes se compararon los resultados de las escalas pre y postoperatorias mediante el test no paramétrico de Wilcoxon. Resultados: participaron 20 mujeres en el estudio. La media de edad de 39,8 años (desviación estándar 11,11). La media del tejido extirpado fue 1.794 g (rango 477-3.000 g). la estancia media hospitalaria fue de 3,1 días (rango 1-7 días). Al mes de la reducción mamaria se observó una mejoría significativa del estado de ansiedad (p<0,0001) y de depresión (p=0,016), así como del dolor en hombros y espalda (p<0,0001). La salud mental de las mujeres mejoró significativamente después de la cirugía. El 90% se mostró satisfecha con los resultados de la intervención, y el 95% manifestó que le gustaban sus pechos después de la cirugía. Conclusiones: la macromastia afecta negativamente a la calidad de vida de las mujeres que la padecen. La reducción mamaria produce una mejoría significativa en un corto plazo de tiempo, tanto en los síntomas físicos como en los aspectos psíquicos (AU)

Objectives: to assess the evolution at short term of psychosocial and clinical parameters in women with macromastia after breast reduction. Methodology: an observational prospective study in women with macromastia after breast reduction managed in the Hospital Clínico Universitario Lozano Blesa, in Zaragoza. Sociodemographical and clinical data were collected, as well as psychosocial and quality of life parameters. This information was collected at two time points: before the procedure (baseline) and at one month after the procedure, through different questionnaires: identification of specific symptoms of macromastia, quality of life through the SF-36 Health Questionnaire, anxiety and depression through the HADS tool, and the Body Dissastisfaction sub-scale in EDI-2. In order to estimate if there were changes in patient status, the scale outcomes before and after the surgical procedure were compared through Non-parametric Wilcoxon Test. Results: twenty (20) women were included in the study. Their mean age was 39.8 years (standard deviation: 11.11). The mean tissue removed was 39.8 years (standard deviation: 11.11). The mena tissue removed was 1,794 g (477-3.000 g range). The mean hospital stay was 3.1 days (1-7 days range). At one month of breast reduction, a significant improvement was observed in the level of anxiety (p< 0.001) and depression (p= 0.016), as well as in shoulder and back pain (p< 0.0001). There was a significant improvement in the mental health of women after surgery; 90% were satisfied with the surgical procedure outcomes, and 95% stated that they liked their breasts after surgery. Conclusions: macromastia has a negative impact on the quality of life of those women who suffer it. Breast reduction causes a significant improvement at short term, both in physical symptoms and in psychological aspects (AU)

Reduction mammaplasty improves levels of anxiety, depression and body image satisfaction in patients with symptomatic macromastia in the short and long term.

OBJECTIVE: To evaluate the psychological consequences (anxiety, depression and body image dissatisfaction) of symptomatic macromastia and the effectiveness of breast reduction surgery in re-establishing the mental health of the patient in the short and long term. METHOD: 119 patients over 18 years old who had been diagnosed with symptomatic macromastia were assessed, before surgery, one month after the operation and one year later. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Body Image Dissatisfaction subscale of the Eating Disorders Inventory (EDI-2). Participants were also asked about their physical appearance, social relationships and their satisfaction with regards to clothing and dress. RESULTS: The average age of the patients was 40.7 (SD = 12.02), 80.2% had a body mass index ≥25 kg/m2. Before surgery, we found psychological distress with values indicating clinical anxiety and body image dissatisfaction. Younger women (< 36 years old) were more psychologically affected. At one month after surgery, there were significant improvements: there were lower scores for anxiety (p < 0.001), depression (p < 0.001) and body image dissatisfaction (p < 0.001). When compared with the pre-surgery scores, all these results showed improvement one year after the intervention (p < 0.001). There were also improvements in social relationships (p < 0.001) and satisfaction with clothing and dress. CONCLUSION: Reduction mammaplasty can alleviate the psychological impact of symptomatic macromastia.

Quality of Life Following Symptomatic Macromastia Surgery: Short- and Long-term Evaluation.

UNLABELLED: Mammary hypertrophy or macromastia can cause a wide range of symptoms (physical, psychosomatic or behavioral), which affect patients' quality of life. Breast reduction can, in most of the cases, solve the problem. However, certain factors could have a negative effect on the outcome of surgery. The aims of this study were to discover the degree of patient satisfaction (short- and long-term) and to evaluate results of reduction mammoplasty, and also to ascertain which factors may have a negative role on the effectiveness of breast reduction surgery. We carried out a prospective and longitudinal study of 121 patients who underwent breast reduction surgery. Quality of life, outcome of surgery (complications and sequelae) and degree of patient satisfaction were evaluated at 1 month and at 1 year after reduction mammoplasty. Mean patient age was 40.71 (SD = 12.02). Among them, 35.5% were overweight, 44.6% were obese and 34.7% were smokers. The most common symptom was pain. The mean amount of resected breast tissue was 1785 g (SD = 876). A total of 27.3% of the patients suffered complications and 30.60% suffered sequelae. Our results show an improvement in symptoms (p < 0.001) and quality of life (p < 0.001 to p = 0.002) 1 month after and 1 year after breast reduction compared with the preoperative situation. Neither age, body mass index, smoking habit nor the amount of tissue removed had a negative effect on the results of surgery. One year after surgery, the majority of patients were satisfied with the outcome (96.6%), they would recommend it to others (96.6%), and they would undergo surgery a second time (95.8%). CONCLUSIONS: Breast reduction is highly efficient in resolving symptoms and in improving quality of life. It leads to a high level of short- and long-term satisfaction irrespective of each patient's individual characteristics.