Factors contributing to patient-reported satisfaction with breast augmentation six months postoperatively.

[BACKGROUND] Breast augmentation continues to be a popular procedure with high outcome satisfaction; however, dissatisfied patients still remain. To understand this outcome variability, this study aimed to identify factors that may influence satisfaction with the breasts postoperatively.

[METHODS] Primary breast augmentation patients were included in a multicenter observational cohort study (2016-2021). The primary outcome was satisfaction with breasts six months postoperatively measured using the BREAST-Q. Hierarchical multivariable regression analyses were performed in six steps including 1) patient characteristics, 2) preoperative anatomical breast characteristics, 3) implant characteristics and technique, 4) preoperative BREAST-Q scores, 5) postoperative anatomical breast characteristics, and 6) postoperative BREAST-Q scores. The final model included 27 determinants.

[RESULTS] For the analyses, 1058 patients were included. Patient characteristics, preoperative and postoperative anatomical breast characteristics, and preoperative BREAST-Q scores together could only explain 6% of the variance in satisfaction with breasts. After including the postoperative BREAST-Q scores, 34% could be explained. The final model showed that greater age, higher preoperative satisfaction with breasts, higher clinician visual analogue scale appearance, and higher postoperative psychosocial, physical, and sexual well-being were independently associated with greater satisfaction with breasts.

[CONCLUSION] Although we included a comprehensive set of determinants, only small effects were found and most variance continued to be unexplained. Strikingly, patient, anatomical breast, and implant characteristics were of limited value in explaining the satisfaction with their breasts. Future studies should investigate which variables are important in explaining the remaining variance to fully comprehend the determinants of patient satisfaction.