ArticleAesthetic plastic surgery2026
RealSelf Assessment of Patient Narratives and Drivers of Dissatisfaction Following Augmentation-Mastopexy: A Quantitative and Qualitative Analysis.
Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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Authors and funding
4 authors.
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Abstract
backgroundAugmentation-mastopexy is a technically demanding procedure associated with high rates of dissatisfaction. Beyond complication and revision rates, less is known about the subjective drivers of dissatisfaction. This study evaluated whether negative online reviews following augmentation-mastopexy can yield insights for practice.
methodsA mixed-methods analysis was conducted on 327 consecutive RealSelf augmentation-mastopexy reviews rated as 'Not Worth It' or 'Not Sure' from 2015-2025. Patient-reported complications, surgeons' credentials, cost, reasons for dissatisfaction and patient-submitted photographs were analysed. Surgeon credentials were verified using national registers and compared to a comparator cohort of positive reviews over the same timeframe. A thematic analysis was performed to explore patients' subjective experiences.
resultsThe most common patient-reported complications were asymmetry (20.0%) and implant malposition/displacement (19.9%). While dissatisfaction with surgical outcome was the most cited factor (97.2%), most reviews (68.2%) highlighted multiple concerns. These included issues with bedside manner (40.7%), value for money (43.1%), and inadequate aftercare (33.9%). Three overarching themes emerged: (1) dissatisfaction driven by dismissal of patient concerns or lack of accountability, (2) negative outcomes linked to a perceived lack of planning, and (3) lack of financial transparency related to revision costs. The representation of non-certified/'cosmetic surgeons' was approximately two-fold higher in the negative review cohort (5.8% vs 2.7%). Notably, 21.7% of patient-submitted photographs showed no visible complications. Median reported cost was $10,000.
conclusionDissatisfaction following augmentation-mastopexy is multifactorial. This study highlights the need for improved patient communication, expectation management, and financial transparency in order to improve satisfaction and preserve trust when complications arise. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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