Intraoperative pulmonary function dynamics in adolescents undergoing reduction mammoplasty: A prospective case series

Abstract

B ilateral breast reduction mammoplasty has become one of the most common procedures in plastic surgery (1). Women with macromastia commonly complain about chronic neck, shoulder and back pain, intertriginous rashes, painful brassiere strap grooving and spinal kyphosis. One of the common motivators for women to undergo breast reduction is to alleviate physical complaints as a result of the heaviness of their breasts, which may also limit their physical and social daily activities (2). Reduction mammoplasty offers both aesthetic and functional benefits to women with macromastia. Recently, this operation has become more popular in adolescent populations, demonstrating safety and effectiveness. The rise in its popularity is attributed mainly to the functional and social disabilities associated with juvenile macromastia (1). Major improvements in quality of life and subjective feeling of lightness and improvement in physical fitness are commonly described among patients undergoing bilateral breast reduction. Several studies seek a physiological basis, assessing the objective improvement of pulmonology function. These have reported an improvement in postoperative pulmonary function in adult populations following reduction mammoplasty, relating it to improvement in the chest wall compliance (3,4). These studies, however, did not include adolescent patients, and have no documentation of the effect of the surgery on intraoperative pulmonary function. The primary objective of the present study was to assess whether improvement in pulmonary dynamic compliance can be determined intraoperatively in adolescents. METHODS Study design and settings A prospective case series of adolescent patients 13 to 18 years of age, who were scheduled to undergo reduction mammoplasty at Texas Children's Hospital (Houston, USA), between November 20, 2006 and April 4, 2011, was conducted. The study was approved by the local institutional review board and the parents of each juvenile patient provided written informed consent. All patients were referred to a plastic surgery clinic by a pediatrician.