Analysis of Satisfaction and Well-Being Following Breast Augmentation Using a Validated Survey Instrument: The BREAST-Q

Purpose: Improvements in satisfaction and quality of life following breast augmentation have been shown in the literature. However, few studies have used validated survey instruments. The BREAST-Q is the only questionnaire for breast augmentation that meets international and federal standards for questionnaire development. Therefore, the aim of this study was to implement this most rigorously tested survey to analyze patient reported satisfaction/dissatisfaction and quality of life following breast augmentation.

Methods: With IRB approval, all patients seen in consultation for breast augmentation between January 2008 and May 2009 by the senior author, AT, were asked to fill out BREAST-Q surveys anonymously during the pre-operative and 6-week post-operative periods. Statistical analysis was performed using Mann-Whitney-U test, Fischer’s exact test, and Pearson’s correlation coefficient. A p-value of <0.05 was considered significant.

Results: 208 patients underwent breast augmentation, using a retropectoral pocket, by a single surgeon (AT) during the study time period. Of these patients, 59(28%) completed the pre-augmentation survey and 70(34%) completed the post-augmentation survey. Significant improvements were seen for the means of every question on satisfaction with breast appearance(p<0.001), psychosocial well-being(p<0.001), and sexual well-being(p<0.01) between pre-augmentation and post-augmentation surveys. Post-operatively, 93% of respondents were very satisfied with how their breast size matched the rest of their body, 88% with how they look in the mirror clothed, and 79% with the size of their breasts, from pre-operative values of 2%, 5% and 0% respectively(p<0.001). Conversely, significant decreases were seen for the means of every question on functional well-being(p<0.001). Post-operatively, 19% of respondents experienced pain and 19% had tightness in the breast area at least some of the time, from pre-operative values of 3% and 0% respectively(p=0.02, p<0.001). Satisfaction with overall outcomes most strongly correlated to satisfaction with appearance of breasts(r=0.9), and less strongly with psychosocial well-being, sexual well-being, and satisfaction with care(r=0.6). The weakest correlation was found between satisfaction with overall outcomes and physical well-being(r=0.1). 

Conclusion: As the implementation of evidence-based medicine continues to grow in everyday practice, there is increasing pressure to use validated survey instruments to demonstrate patient reported outcomes. Using the validated BREAST-Q, we have shown that breast augmentation significantly improves satisfaction with breast appearance, psychosocial well-being and sexual well-being, and that overall satisfaction is most strongly correlated with satisfaction in appearance of their breasts.