Surgical Treatment of Breast Asymmetry Improves Quality of Life in Adolescents and Young Women

PURPOSE: Persistent breast asymmetry beyond skeletal maturity of at least one cup-size difference is associated with psychosocial deficits. This longitudinal cohort study measures the impact of surgical correction of breast asymmetry on adolescent health-related quality of life.

METHODS: Validated surveys were administered to skeletally mature females with breast asymmetry undergoing surgical correction and comparably aged female controls: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), and Eating-Attitudes Test-26 (EAT-26). Cohorts completed surveys at baseline and postoperatively/follow-up at 6 months, 1 year, 3 years, 5 years, and 7 years.

RESULTS: The mean ages of breast subjects (n=42) at surgery and controls (n=103) at baseline were 17.4 and 16.7 years, respectively. All asymmetry forms were included (most frequent size difference was two cups; mean volume difference was 213 mL). At baseline, asymmetry subjects performed significantly worse than controls in the role-emotional SF-36 domain and on the RSES and EAT-26. Postoperatively asymmetry subjects experienced significant improvements in three SF-36 domains (social functioning, role emotional, mental health) and on the EAT-26. These results largely did not vary by age, BMI category, and asymmetry severity. Postoperative asymmetry patients performed equally to controls in all eight SF-36 domains, and on the RSES and EAT-26.

CONCLUSION: Surgical correction of asymmetry in adolescents and young women is associated with improved psychosocial wellbeing, unaffected by age, BMI category, or severity. Postoperatively, breast patients performed comparably to unaffected controls. Providers should be aware of the psychosocial improvements surgery can provide adolescents with persistent, distressing asymmetry.