How Does Volume of Resection Relate to Symptom Relief for Reduction Mammaplasty Patients?

Strong, Ben; Hall-Findlay, Elizabeth J.

doi:10.1097/sap.0000000000000190

Cited by 42 publications

(30 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our ndings also demonstrated that all patients had a signi cant improvement in pain following surgery and this improvement in pain was unaltered at 6 months post procedure. These ndings of improvement in pain and outcome are consistent with similar studies performed on this subject [16][17][18][19].…”

Section: Discussionsupporting

confidence: 91%

Clinical and quality of life outcomes following reduction mammoplasty for symptomatic macromastia among Sri Lankan women: a prospective cohort study

Wijesinghe

Jayarajah

Mallawaarachchi

et al. 2022

Preprint

View full text Add to dashboard Cite

Background The impact of macromastia is unfortunately underestimated among the developing South Asian countries. The resulting distress can make it challenging for patients to be physically active and affect their quality of life (QoL). Reduction mammoplasty is a standard treatment option for people suffering from symptomatic macromastia. Therefore we aimed to evaluate the efficacy of reduction mammoplasty in alleviating symptoms of macromastia and its impact on quality of life among Sri Lanka females. Methods A prospective study was conducted among 48 patients who underwent reduction mammoplasty in a surgical unit at National Hospital of Sri Lanka from 2016 January to 2021 January. SF-36 questionnaire which is validated in Sri Lanka was used to assess the quality of life. To assess pain related to macromastia, a visual analogue scale was used from 0 to 10 according to the level of intensity. The outcomes were assessed one week prior to surgery and at 2 weeks and 6 months after surgery. Results Median age was 43 years and median BMI was 26.8 kg/m2. The commonest presentation was breast and musculoskeletal pain (100%), shoulder grooving (81.3%) and sub-mammary intertrigo (37.5%). The average duration of symptoms was 2 years. All patients initially being reluctant to seek medical advice. Only 10.4 % of patients were aware of availability of treatment. Wise pattern reduction mammoplasty was performed in 79.2%. The commonest complications were wound dehiscence (4/48) followed by surgical site infection (2/48) and nipple necrosis (1/48). There was a significant improvement in satisfaction with breast aesthetics and reduction in pain following surgery. There was also an improvement in all 8 domains of the quality of life following surgery in comparison to the pre-operative scores especially in general health, pain and physical functions. Conclusion Our study clearly demonstrated that reduction mammoplasty caused a significant improvement in the overall quality of life and psychological wellbeing with significant reduction in pain for patients suffering from macromastia. Creating more awareness among the public to encourage women to openly discuss about breast related symptoms and to overcome socio cultural taboos and barriers is a timely necessity.

show abstract

Section: Discussionsupporting

confidence: 91%

Clinical and quality of life outcomes following reduction mammoplasty for symptomatic macromastia among Sri Lankan women: a prospective cohort study

Wijesinghe

Jayarajah

Mallawaarachchi

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Alternatively, a one-band size increase (e.g. [12][13][14] with no change in cup size is also a 1-point increase in BSS. In a subset of 119 participants, 42 BSSs derived from self-reported bra size data correlated significantly (r = 0.8, p < 0.001) with BSSs derived from investigator measured under and over bust circumferences.…”

Section: Methodsmentioning

confidence: 99%

“…Increasing breast size, noted by women as they get older, may be particularly problematic for women’s health and psychological wellbeing if the burden associated with large breasts that has been suggested in prior work is considered. Increased breast size has previously been related to reduced health and psychological wellbeing in studies of women undergoing reduction mammoplasty surgery where a range of negative physical 12–14 and psychological characteristics 13–22 have been attributed to having large or excessively large (hypertrophic) breasts. Characteristics that have been most widely examined and which show improvement following reduction mammoplasty include low quality of life, 16,17,19,21,23 body dissatisfaction, 15 low breast satisfaction, 16,19,24 depression, 18,20 upper back pain 14,25 and physical activity limitations.…”

Section: Introductionmentioning

confidence: 99%

The relationship between breast size and aspects of health and psychological wellbeing in mature-aged women

Spencer

Fary

McKenna

et al. 2020

Womens Health (Lond Engl)

View full text Add to dashboard Cite

Objectives: Increases in breast size with age are common but have not been widely examined as a factor that could affect the health and psychological wellbeing of mature-aged women. The purpose of this study was to examine the relationships between breast size and aspects of health and psychological wellbeing in mature-aged women. Methods: This was a cross-sectional study of mature-aged women (⩾40 years). Breast size (breast size score) was determined from self-reported bra size and was examined against health-related quality of life (Medical Outcomes Study Short-Form 36 and BREAST-Q), body satisfaction (numerical rating scale), breast satisfaction (BREAST-Q), physical activity levels (Human Activity Profile), the presence of upper back pain and breast and bra fit perceptions. Results: Two hundred sixty-nine women (40–85 years) with bra band sizes ranging from 8 to 26 and bra cup sizes from A to HH participated. The mean (standard deviation) breast size score of 7.7 (2.7) was equivalent to a bra size of 14DD. Increasing breast size was associated with significantly lower breast-related physical wellbeing ( p < 0.001, R2 = 0.043) and lower ratings of body ( p = 0.002, R2 = 0.024) and breast satisfaction ( p < 0.001, R2 = 0.065). Women with larger breasts were more likely to be embarrassed by their breasts (odds ratio: 1.49, 95% confidence interval: 1.31 to 1.70); more likely to desire a change in their breasts (odds ratio: 1.55, 95% confidence interval: 1.37 to 1.75) and less likely to be satisfied with their bra fit (odds ratio: 0.84, 95% confidence interval: 0.76 to 0.92). Breast size in addition to age contributed to explaining upper back pain. For each one-size increase in breast size score, women were 13% more likely to report the presence of upper back pain. Conclusion: Larger breast sizes have a small but significant negative relationship with breast-related physical wellbeing, body and breast satisfaction. Larger breasts are associated with a greater likelihood of upper back pain. Clinicians considering ways to improve the health and psychological wellbeing of mature-aged women should be aware of these relationships.

show abstract

Section: Recommendationsmentioning

confidence: 99%

“…25 The evidence demonstrates that resection weight does not accurately predict patient-oriented outcomes such as alleviation of pain and related symptoms, and should not be the primary determinant of medical necessity. 2,3,[8][9][10]24,[27][28][29][30][31] The Breast Reduction Assessment of Value and Outcomes study proposed a new symptombased definition of medical necessity for reduction mammaplasty. 25 It recommends a simplified instrument, the Physical Symptoms Count, to The presence of two or more of these symptoms, occurring most or all of the time, successfully differentiated a group of reduction mammaplasty patients from a control group containing both nonhypertrophic and hypertrophic subjects: 89.9 percent of operative subjects reported experiencing two or more symptoms all or most of the time, compared with only 2 percent of normal controls.…”

Section: Rationalementioning

confidence: 99%

American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty

Perdikis

Dillingham

Boukovalas

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Summary: A multidisciplinary work group involving stakeholders from various backgrounds and societies convened to revise the guideline for reduction mammaplasty. The goal was to develop evidence-based patient care recommendations using the new American Society of Plastic Surgeons guideline methodology. The work group prioritized reviewing the evidence around the need for surgery as first-line treatment, regardless of resection weight or volume. Other factors evaluated included the need for drains, the need for postoperative oral antibiotics, risk factors that increase complications, a comparison in outcomes between the two most popular techniques (inferior and superomedial), the impact of local anesthetic on narcotic use and other nonnarcotic pain management strategies, the use of epinephrine, and the need for specimen pathology. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development and Evaluation methodology). Evidence-based recommendations were made and strength was determined based on the level of evidence and the assessment of benefits and harms.

show abstract

How Does Volume of Resection Relate to Symptom Relief for Reduction Mammaplasty Patients?

Cited by 42 publications

References 18 publications

Clinical and quality of life outcomes following reduction mammoplasty for symptomatic macromastia among Sri Lankan women: a prospective cohort study

Clinical and quality of life outcomes following reduction mammoplasty for symptomatic macromastia among Sri Lankan women: a prospective cohort study

The relationship between breast size and aspects of health and psychological wellbeing in mature-aged women

American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty

Contact Info

Product

Resources

About