“Surgery of Congenital Breast Asymmetry – Which Objective Parameter Influences the Subjective Satisfaction With Long-term Results?”

Abstract Purpose: Congenital breast asymmetry is a serious gynaecological malformation for affected patients. The phenotyping hits young women in puberty and is associated with a socio-aesthetic handicap, depression and psychosexual problems. Therefore, the time of therapy is usually early in view of the patient's entire life so that a sustainable solution is important. Although, postoperative outcome has been evaluated in several studies before, this study firstly analyses which objective parameters have the most influence on subjective satisfaction with long-term results.Methods: 34 patients with a diagnosed congenital breast asymmetry that underwent either lipofilling or implant therapy in the years of 2008 - 2019 were examined. On average, our collective was seven years postoperatively. Data was mainly gathered by manual measurements, patient-reported outcome measures (Breast Q™) and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific).Results: Among all analysed parameters, only the areola diameter correlated significantly negative with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of the postoperative satisfaction with similarity of the breasts, again the mean of areola diameter, the difference of areola diameter between right and left breast and the difference of volume assessed with 3D scans correlated significantly negative.Conclusion: The areola diameter was shown to be a significant influencing factor for patient-subjective long-term satisfaction in breast asymmetry patients. Besides, 3D volumetry was shown to be a good tool for objectifying patient subjective assessments. Our findings could lead to further improvement of surgical planning and will be built upon in further studies.