Abstract
Purpose
To assess age-related differences in appearance satisfaction among women.Methods
This Danish nationwide survey- and register-based study included women aged 20-79 years undergoing elective primary ventral hernia repair (defect width ≤ 4 cm) between 2014-2024. Patient-reported outcomes from the AFTERHERNIA Project included postoperative scar dissatisfaction and overall appearance satisfaction, assessed with the Abdominal Hernia-Q (AHQ) appearance sum score (range 5-20; lower scores indicate worse outcome) and preoperative appearance-related motivation for surgery. Survey data were linked to registry data from the Danish Ventral Hernia Database. Outcomes were analyzed using regression models with marginal standardization.Results
Among 6,018 eligible patients, 4,704 (78%) responded. Younger women were more dissatisfied with their scar, with the highest adjusted prevalence among patients aged 20-29 (26.7% [95% CI 17.3-38.8]) and the lowest among those aged 60-69 (7.6% [95% CI 4.5-12.6]). Younger women were also more dissatisfied with their overall appearance, with adjusted mean AHQ appearance sum scores increasing across the same age groups (16.0 points [95% CI 15.2-16.7] to 18.2 points [95% CI 17.5-18.8]). Among the 1,223 patients reporting appearance-related motivation for surgery, 70-87% experienced postoperative improvement, with the lowest proportion among patients aged 20-29. Results were consistent across sensitivity and subgroup analyses.Conclusion
Young women were more dissatisfied with both the postoperative scar and overall appearance compared with older age groups. Although most women motivated for surgery by appearance reported postoperative improvement, the youngest remained the most dissatisfied, highlighting the importance of preoperative expectation management.