BACKGROUND: Breast augmentation ranks among the most popular plastic surgery procedures. Yet, reports on post-operative patient-reported quality of life (QoL) and satisfaction remain conflicting. METHODS: A systematic review was conducted following the PRISMA guidelines. Three databases were searched for eligible studies that reported pre-and/or post-operative Breast-QTM augmentation scores for patient QoL (psychosocial, sexual, and physical well-being) and/or satisfaction. RESULTS: A total of 39 studies (53 patient cohorts and 18,322 patients) were included in the quantitative synthesis. The pairwise meta-analysis revealed significant improvements in patient-reported psychosocial (MD: +38.10) and sexual well-being (MD: +40.20) as well as satisfaction with breast (MD: +47.88) (all p < 0.00001). Physical well-being improved slightly after breast augmentation (MD: +6.97; p = 0.42). The single-arm meta-analysis yielded comparable results, with Breast-QTM scores in psychosocial and sexual well-being as well as satisfaction with breast increasing from 37.2, 31.1, and 26.3 to 75.0, 70.6, and 72.7, respectively (all p < 0.00001). Physical well-being improved by 8.1 (75.8 pre-operatively to 83.9 post-operatively; p = 0.17). Subgroup analyses highlighted higher QoL and satisfaction following breast augmentation for purely esthetic purposes and alloplastic mammaplasty. Although patient-reported physical and sexual well-being increased in the long term, psychosocial well-being was the highest in the short term. CONCLUSION: Patient satisfaction with breast, psychosocial, and sexual well-being increased significantly after breast augmentation. In contrast, patient-reported physical well-being yielded ambivalent results, varying by mammaplasty technique and post-operative follow-up time. Plastic surgeons should be sensitized about our findings to refine eligibility criteria and gain a deeper understanding of the patients' perceived surgical experience. PROSPERO TRIAL REGISTRATION NO: CRD42023409605.

Department of Hand Plastic and Reconstructive Surgery Burn Center BG Trauma Center Ludwigshafen University of Heidelberg Ludwigshafen Germany

Department of Plastic Aesthetic Hand and Reconstructive Surgery Hannover Medical School Hannover Germany

Department of Plastic Reconstructive Hand and Burn Surgery Bogenhausen Academic Teaching Hospital Munich Munich Germany

Department of Plastic Surgery and Hand Surgery Klinikum Rechts der Isar Technical University of Munich Munich Germany

Department of Plastic Surgery and Hand Surgery University Hospital Zürich Zurich Switzerland

Division of Plastic Surgery Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston MA USA

Division of Plastic Surgery Department of Surgery Yale School of Medicine New Haven CT USA

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