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Jurell G, and Lohjelm L (2007) Prospective study comparing two brands of cohesive gel breast implants with anatomic shape: 5-year follow-up evaluation Aesthetic Plastic Surgery 31(6): 697-710. 21 Stokes RB (2004) Breast augmentation in thin women: patient satisfaction with saline-filled implants Aesthetic Plastic Surgery 28(3): 153-7. 7 also indicated by a further small US study of 13 BA recipients. 22 However, a Chinese study of 144 BA recipients found that 76 per cent of participants indicated that they were ‘satisfied’ with the outcome, which the authors suggest is a low rate.23 Gynaecomastia This review identified one study which examined levels of satisfaction among male recipients of surgery to address gynaecomastia. In this study of 74 male recipients, the authors conclude that 62.5 per cent of patients were ‘satisfied’ to ‘very satisfied’ with the results, concluding that “this more detailed study has shown that satisfaction rates are not as high as previously published. Patients must be appropriately counselled postoperatively to ensure they have realistic expectations of what can be achieved with surgery.”24 Cosmetic facial procedures A small number of studies explore satisfaction rates among participants who have undergone facial procedures, for example where people have received injectable substances, rhinoplasty, or procedures focused on the teeth / jaws. For example, with procedures to smooth frown lines between the eyebrows (glabellar rhytides), one study found recipient-reported satisfaction was 95 per cent 30 days after the procedure, and 86 per cent at 120 days after the procedure.25 In addition, a low rate of regret is noted in the results of a study involving recipients of orthognathic surgery: two years following the procedure, eight per cent of participants regretted having undergone the operation.26 Rhinoplasty procedures have also been reported to have a high level of patient satisfaction. For example, a study of secondary rhinoplasties (undertaken where the primary rhinoplasty was deemed unsatisfactory, predominantly because of the development of a “new deformity”) found that 97 per cent of participants were happy 22 Spear S, Pelletiere C, and Menon N (2004) One-stage augmentation combined with mastopexy: aesthetic results and patient satisfaction Aesthetic Plastic Surgery 28(5): 259-67. 23 Shi H, Cao C, Li X, Chen L, and Li S (2015) A retrospective study of primary breast augmentation: recovery period, complications and patient satisfaction International Journal of Clinical and Experimental Medicine 8(10): 18737-43. 24 Ridha H, Colville RJI, and Vesely MJJ (2009) How happy are patients with their gynaecomastia reduction surgery? Journal of Plastic, Reconstructive & Aesthetic Surgery 62(11): 1473-8. 25 Stotland MA, Kowalski JW, and Ray BB (2007) Patient-reported benefit and satisfaction with botulinum toxin type A treatment of moderate to severe glabellar rhytides: results from a prospective open-label study Plastic and Reconstructive Surgery 120(5): 1386. General satisfaction among Botox recipients is also observed by Sepehr A, Chauhan N, Alexander A, and Adamson P (2010) Botulinum toxin Type A for facial rejuvenation: treatment evolution and patient satisfaction Aesthetic Plastic Surgery 34(5): 583-6. 26 Zhou Y, Hägg U, and Rabie A (2000) Patient satisfaction following orthognathic surgical correction of skeletal Class III malocclusion The International Journal of Adult Orthodontics and Orthognathic Surgery 16(2): 99-107. 8 with the secondary procedure.27 However, in an exploration of satisfaction rates for recipients who have been diagnosed with body dysmorphic disorder (BDD), a UK study of 25 participants who had undergone a total of 46 procedures found that, for those who had received rhinoplasty, satisfaction rating was relatively low. The author of the study also reported that “after 50% of the procedures the preoccupation transferred to another area of the body.” Indeed, as more procedures were performed on this group, satisfaction levels fell from a rate of 3.9 after one procedure, to 2.8 by the second or third procedure. The study also observed that nine of the participants “either in desperation at being turned down for cosmetic surgery or because they could not afford it, had performed their own ‘DIY’ surgery in which they attempted by their own hand to alter their appearance dramatically.”28 Among younger research participants, very high levels of satisfaction were observed in a German study of 41 child otoplasty patients, which found that 95 per cent of those children were satisfied with the aesthetic result of the procedure.29 In addition, regret levels among 50 child recipients of otoplasty are indicated as low (n=2) by a further study. 30 Dental procedures In relation to procedures that focus on the teeth / mouth / jaw, the evidence also suggests good rates of satisfaction. For example, recipients of overdentures have indicated good levels of satisfaction one year after the procedure was carried out. 31 Orthognathic (jaw) surgery recipients in a Turkish study of 30 female recipients of the procedure indicated high levels of satisfaction with the surgical results: 77 per cent were very satisfied; 17 per cent were satisfied; three per cent were satisfied; and three per cent were not satisfied.32 Similarly, the overall rate of recipients who expressed satisfaction as a result of orthognathic
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