title: A prospective study of short- and long-term cosmetic outcome after reduction mammaplasty from three different perspectives:  the patient, a department surgeon, and an independent private practitioner in plastic surgery.
abstract: BACKGROUND
  Numerous studies have examined the outcome of reduction mammaplasty. This study evaluates the cosmetic outcome after reduction mammaplasty from the perspective of the patient, a ward surgeon, and a private practitioner in plastic surgery, and analyzes which factors influence it.
  
  
  METHODS
  The material stems from a Danish quality assurance program in the public health care system. Nonparametric statistics and logistic regression were used to compare cosmetic outcomes and possible confounding.
  
  
  RESULTS
  Over 80 percent of the patients evaluated the short- and long-term cosmetic outcome as good or very good. The surgeons and especially the private practitioner were more critical. The evaluation of breast features also differs between patients and surgeons. The main issue for patients is symmetry. With time, patients and the private practitioner become more critical about the scars. Surgeons are most concerned about nipple bottoming out. Predictive factors for surgeons were the patient's age, body mass index, and postoperative complications. Evaluation by patients was, in addition to complications, influenced by the preoperative information given, confidence in the treatment, and the overall course on the ward.
  
  
  CONCLUSIONS
  Patients evaluate cosmetic outcome significantly more favorably than surgeons and especially the private practitioner. They are also concerned about different breast features. Decreased nipple sensation does not influence the patient's evaluation. Evaluation by the surgeons depends on more objective measures than does evaluation by the patients. One must not underestimate the importance of factors such as preoperative information about the surgery and complications, together with proper and qualified care.
  
  
  METHODS
  Therapeutic, II.
authors: Herlev, Copenhagen, and Roskilde, Denmark From the Department of Plastic Surgery, Herlev, Copenhagen University Hospital, Denmark.
authors: Line Bro
authors: LB
authors: Breiting
authors: Trine Foged
authors: TF
authors: Henriksen
authors: Louise Vennegaard
authors: LV
authors: Kalialis
authors: Christina
authors: C
authors: Gramkow
authors: Anette Pernille
authors: AP
authors: Høyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001828:Body Image; D002921:Cicatrix / Q000209:etiology / Q000523:psychology; D003718:Denmark; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology; D011331:Private Practice; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D018709:Statistics, Nonparametric; D013503:Surgery Department, Hospital; D055815:Young Adult