[Reduction mammaplasty in Reykjavik, Iceland 1984-1993; An outcome analysis.].
Breast reduction is an established and effective operation in reducing symptoms of macromastia (Hyperplasia mammae). This is one of the most common operation done by plastic surgeons today.


OBJECTIVE
The purpose of this retrospective descriptive analysis was to determine the results of bilateral reduction mammaplasty in the period 1984-1993, at the department of Plastic Surgery, National University Hospital, Reykjavík, Iceland.


METHODS
Three plastic surgeons performed most of the operations (96%) and used different operation methods. Data from 277 patient charts was reviewed, and a total of 258 women were included in the study. Calculation of the complication rate was made for the whole group and each surgeon. A questionnaire form was sent to all of the 258 women that underwent bilateral reduction mammaplasty due to macromastia. Preoperative symptoms, the experience of the operation and lastly the patients opinion of the overall result of the operation were evalueted. 195 (75.5%) of the patients responded.


RESULTS
28 patients or 11.5% had major complications (needed reoperation) and 69 patients or 28.5% had minor complications. The minor complications healed in a short time (a few weeks), but it is possible that the surgeons did not register all the minor complications equally. Of the major complications half needed reoperation within the first two days because of bleeding/hematoma and the other half needed reoperation later for other resons. The rate of major complications varied from 9% to 14.5% between the surgeons. The most common complication was necrosis of the skin (39% of the complications). Other common complications were minor wounds (18.5%), bleedings (15.5%), infections (11.5%), and dehiscence (8%). Data from the questionnaire indicated that 94% of the patients had physical symptoms and 82% had also emotional symptoms preoperatively. 81% thought the overall result was very good or good. 44% of the patients thought the main disadvantage of the operation was scar appearance. 84% thought the operation met their expectations in all (50%) or most regards (34%). 91.5% of the women would recommend operation to a friend. 66% said that macromastia was in the family.


CONCLUSIONS
The overall results of this study indicate that reduction mammaplasty is an effective method in relieving symptoms due to macromastia and that, despite the complications, the majority of the operated women were pleased with the results.
Knútsson
Kári
K
Department of Surgery, Akranes Hospital, 300 Akranesi, Iceland. kari.knutsson@sha.is.
Einarsson
Olafur
O