Log in

Impact of Incisional Access Site in Primary Breast Augmentation: Evaluation of Patient Satisfaction with SCAR-Q

  • Original Articles
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Scarring at the incision site represents one of the most impactful outcomes in breast augmentation surgery for both the patient and the surgeon. Few studies exist with the aim of assessing patient perception of scarring outcomes in primary breast augmentation. The aim of this study was to evaluate the impact on quality of life of scars by submitting the SCAR-Q in patients who underwent primary augmentation mammoplasty.

Methods

The SCAR-Q was administered at one and at 6 months after surgery to 54 consecutive patients underwent primary breast augmentation with inferior hemi-periareolar or inframammary incision. A total of 50 patients were divided into two groups of 21 patients with inferior hemi-periareolar incision and 29 patients with inframammary fold incision, respectively. Statistical analysis was performed with Prism 9.

Results

All mean values of the three SCAR-Q scales tend to decrease at the second administration meaning that the perception of the scar is better at time 6 from the patient perspective. In the “Psychosocial scale,” lower values at both 1 month and 6 months for group 2 compared to group 1 were shown. Unpaired T tests with Welch’s correction showed significance for delta values variations between the two groups with P values <0.0001.

Conclusion

Data show that patients undergoing primary breast augmentation have a scar that has no significant impact. Patients with inframammary fold scar have less psychosocial impact than those with inferior hemi-periareolar scar. There were no statistically significant differences in scar-related symptoms and scar appearance between scar along the inframammary groove and inferior hemi-periareolar scar.

Level of Evidence IV

Case series study. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Adams WP, Mallucci P (2012) Breast augmentation. Plast Reconstr Surg 130(4):597e–611e. https://doi.org/10.1097/PRS.0b013e318262f607

    Article  CAS  PubMed  Google Scholar 

  2. Hidalgo DA, Spector JA (2014) Breast augmentation. Plast Reconstr Surg 133(4):567e–583e. https://doi.org/10.1097/PRS.0000000000000033

    Article  CAS  PubMed  Google Scholar 

  3. Bartsich S, Ascherman JA, Whittier S, Yao CA, Rohde C (2011) The breast: a clean-contaminated surgical site. Aesthet Surg J 31(7):802–806. https://doi.org/10.1177/1090820X11417428

    Article  PubMed  Google Scholar 

  4. Stümpfle RL, Piccinini PS, Zanin EM (2021) Transabdominal breast augmentation with silicone gel implants. Ann Plast Surg 87(2):126–131. https://doi.org/10.1097/SAP.0000000000002921

    Article  CAS  PubMed  Google Scholar 

  5. Luan J (2023) Endoscopic-assisted transaxillary breast augmentation. Clin Plast Surg 50(1):151–162. https://doi.org/10.1016/j.cps.2022.08.010

    Article  PubMed  Google Scholar 

  6. Jacobson JM, Gatti ME, Schaffner AD, Hill LM, Spear SL (2012) Effect of incision choice on outcomes in primary breast augmentation. Aesthet Surg J 32(4):456–462. https://doi.org/10.1177/1090820X12444267

    Article  PubMed  Google Scholar 

  7. Widgerow AD (2011) Cellular/extracellular matrix cross-talk in scar evolution and control. Wound Repair Regen 19(2):117–133. https://doi.org/10.1111/j.1524-475X.2010.00662.x

    Article  PubMed  Google Scholar 

  8. Widgerow AD (2011) Current concepts in scar evolution and control. Aesthetic Plast Surg 35(4):628–635. https://doi.org/10.1007/s00266-010-9635-2

    Article  PubMed  Google Scholar 

  9. Baker R, Urso-Baiarda F, Linge C, Grobbelaar A (2009) Cutaneous scarring: a clinical review. Dermatol Res Pract 2009:625376. https://doi.org/10.1155/2009/625376

    Article  PubMed  Google Scholar 

  10. Marshall CD, Hu MS, Leavitt T, Barnes LA, Lorenz HP, Longaker MT (2018) Cutaneous scarring: basic science, current treatments, and future directions. Adv Wound Care (New Rochelle) 7(2):29–45. https://doi.org/10.1089/wound.2016.0696

    Article  PubMed  Google Scholar 

  11. Beanes SR, Dang C, Soo C, Ting K (2003) Skin repair and scar formation: the central role of TGF-beta. Expert Rev Mol Med 5(8):1–22. https://wwww.unboundmedicine.com/medline/citation/14987411/Skin_repair_and_scar_formation:_the_central_role_of_TGF_beta_. Accessed 18 Dec 2022

  12. Levenson SM, Geever EF, Crowley LV, Oates JF 3rd, Berard CW, Rosen H (1965) The healing of rat skin wounds. Ann Surg 161(2):293–308. https://pubmed.ncbi.nlm.nih.gov/14260029/. Accessed 18 Dec 2022

  13. Son D, Harijan A (2014) Overview of surgical scar prevention and management. J Korean Med Sci 29(6):751–757. https://doi.org/10.3346/jkms.2014.29.6.751

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jawanrudi P, Bender R, Pennig D et al (2022) Evaluation of quality of life (BREAST-Q) and scar quality (POSAS) after breast augmentation. Plast Reconstr Surg Glob Open 10(5):e4313. https://doi.org/10.1097/GOX.0000000000004313

    Article  PubMed  PubMed Central  Google Scholar 

  15. Randquist C, Por YC, Yeow V, Maglambayan J, Simonyi S (2018) Breast augmentation surgery using an inframammary fold incision in Southeast Asian women: patient-reported outcomes. Arch Plast Surg 45(4):367–374. https://doi.org/10.5999/aps.2018.00045

    Article  PubMed  PubMed Central  Google Scholar 

  16. White CP, Farhang Khoee H, Kattan AE, Farrokhyar F, Hynes NM (2013) Breast reduction scars: a prospective survey of patient preferences. Aesthet Surg J 33(6):817–821. https://doi.org/10.1177/1090820X13495868

    Article  PubMed  Google Scholar 

  17. Sprole AM, Adepoju I, Ascherman J, Gayle LB, Grant RT, Talmor M (2007) Horizontal or vertical? An evaluation of patient preferences for reduction mammaplasty scars. Aesthet Surg J 27(3):257–262. https://doi.org/10.1016/j.asj.2007.04.007

    Article  CAS  PubMed  Google Scholar 

  18. Celebiler O, Sönmez A, Erdim M, Yaman M, Numanoğlu A (2005) Patients’ and surgeons’ perspectives on the scar components after inferior pedicle breast reduction surgery. Plast Reconstr Surg 116(2):459–466. https://doi.org/10.1097/01.prs.0000173060.02593.3a

    Article  CAS  PubMed  Google Scholar 

  19. van der Willik EM, Terwee CB, Bos WJW et al (2021) Patient-reported outcome measures ( PROMs): making sense of individual PROM scores and changes in PROM scores over time. Nephrology 26(5):391–399. https://doi.org/10.1111/nep.13843

    Article  PubMed  Google Scholar 

  20. Warnakulasuriya SR, Patel RC, Singleton GF, Moonesinghe SR (2020) Patient-reported outcomes for ambulatory surgery. Curr Opin Anaesthesiol 33(6):768–773. https://doi.org/10.1097/ACO.0000000000000921

    Article  PubMed  Google Scholar 

  21. Meadows KA (2011) Patient-reported outcome measures: an overview. Br J Community Nurs 16(3):146–151. https://doi.org/10.12968/bjcn.2011.16.3.146

    Article  PubMed  Google Scholar 

  22. Churruca K, Pomare C, Ellis LA et al (2021) Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues. Health Expect 24(4):1015–1024. https://doi.org/10.1111/hex.13254

    Article  PubMed  PubMed Central  Google Scholar 

  23. Klassen AF, Ziolkowski N, Mundy LR et al (2018) Development of a new patient-reported outcome instrument to evaluate treatments for scars: The SCAR-Q. Plast Reconstr Surg Glob Open 6(4):e1672. https://doi.org/10.1097/GOX.0000000000001672

    Article  PubMed  PubMed Central  Google Scholar 

  24. Peeters MJ, Augustine JM (2023) Using Rasch measurement for instrument rating scale refinement. Curr Pharm Teach Learn 15(1):110–118. https://doi.org/10.1016/j.cptl.2023.02.015

    Article  PubMed  Google Scholar 

Download references

Funding

The authors didn’t receive any financial support for the research, authorship and publication of this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlo Mirra.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights, or Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All participants give their informed consent in writing prior to inclusion in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gratteri, M., Marangi, G.F., Mirra, C. et al. Impact of Incisional Access Site in Primary Breast Augmentation: Evaluation of Patient Satisfaction with SCAR-Q. Aesth Plast Surg 48, 1565–1570 (2024). https://doi.org/10.1007/s00266-023-03502-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-023-03502-z

Keywords

Navigation