Reduction Mammaplasty: Cosmetic or Reconstructive Procedure?

Schnur, Paul; Hoehn, James G.; Ilstrup, Duane M.; Cahoy, Mary J.; Chu, Chu-Pin

doi:10.1097/00000637-199109000-00007

Cited by 87 publications

(60 citation statements)

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“…Diagnosis was based on symptom profile, physical examination, and modified Shnur criteria. 31,32 Subjects with macromastia were prospectively enrolled at the time of initial consultation through the Adolescent Breast Clinic at the Department of Plastic and Oral Surgery at Children's Hospital Boston from October 2008 through August 2011.…”

Section: Subjectsmentioning

confidence: 99%

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

Cerrato

Webb²,

Rosen³

et al. 2012

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Macromastia is associated with severe physical and emotional symptoms and negatively impacts health-related quality of life in adult women. Reduction mammaplasty is the most effective treatment for adults. Little is known regarding the impact of macromastia during adolescence.WHAT THIS STUDY ADDS: Adolescents with macromastia have impaired health-related quality of life, lower self-esteem, more breastrelated symptoms, and are at higher risk for disordered eating in comparison with their peers. These negative health outcomes have implications for early intervention in this patient population. abstract OBJECTIVE: To determine the physical and psychosocial impact of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents. METHODS:The following surveys were administered to adolescents with macromastia and control subjects, aged 12 to 21 years: ShortForm 36v2, Rosenberg Self-Esteem Scale, Breast-Related Symptoms Questionnaire, and Eating-Attitudes Test-26 (EAT-26). Demographic variables and self-reported breast symptoms were compared between the 2 groups. Linear regression models, unadjusted and adjusted for BMI category (normal weight, overweight, obese), were fit to determine the effect of case status on survey score. Odds ratios for the risk of disordered eating behaviors (EAT-26 score $20) in cases versus controls were also determined. RESULTS:Ninety-six subjects with macromastia and 103 control subjects participated in this study. Age was similar between groups, but subjects with macromastia had a higher BMI (P = .02). Adolescents with macromastia had lower Short-Form 36v2 domain, Rosenberg Self-Esteem Scale, and Breast-Related Symptoms Questionnaire scores and higher EAT-26 scores compared with controls. Macromastia was also associated with a higher risk of disordered eating behaviors. In almost all cases, the impact of macromastia was independent of BMI category.CONCLUSIONS: Macromastia has a substantial negative impact on health-related quality of life, self-esteem, physical symptoms, and eating behaviors in adolescents with this condition. These observations were largely independent of BMI category. Health care providers should be aware of these important negative health outcomes that are associated with macromastia and consider early evaluation for adolescents with this condition. Pediatrics 2012;130:e339-e346 AUTHORS:

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Section: Subjectsmentioning

confidence: 99%

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

Cerrato

Webb²,

Rosen³

et al. 2012

Pediatrics

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“…Some studies have tried to find predictive factors for efficient surgery in breast hypertrophy, but without success (11)(12)(13). Patients with smaller resection weights have an equal improvement in breast-related symptoms as patients with greater resections (10,14).…”

mentioning

confidence: 99%

The Outcome of Reduction Mammaplasty is Affected More by Psychosocial Factors Than by Changes in Breast Dimensions

2011

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Background and Aims: Several randomised studies have proved the effects of breast reduction surgery. However, search for predictive factors has not been successful. Therefore we decided to analyse breast dimension changes and to see whether these, or patient characteristics or individual psychosocial factors have an effect on the outcome.Material and Methods: Twenty-nine patients were assessed at baseline and at six months follow-up. Outcome measures used were two health-related quality of life questionnaires, a breast-associated symptoms questionnaire, a pain-rating questionnaire, and a mood questionnaire. Detailed breast dimensions were recorded. Forward stepwise linear regression was applied to detect possible associations between outcome measure changes and breast dimensions or patient-related factors.Results: Preoperatively anxious patients had more improvement in the quality of life index scores, but less improvement in the mental health scores when compared to patients not anxious. Patients with physically demanding work had more improvement in the quality of life index scores and a trend to less improvement in the mental health scores when compared to patients with physically less stressful work. Patients with no overweight had a trend to better improvement in self-esteem.Conclusions: The outcome of reduction mammaplasty is affected more by psychosocial factors than by changes in breast dimensions.

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“…However, financial coverage of the operation is usually restricted by the insurance companies since they are inclined to describe reduction mammaplasty as an aesthetic procedure. They require the documentation of conservative therapy for treatment of macromastia symptoms, and are being increasingly rigid in their requirements of resected tissue weights before approval authorization [5]. Although some companies choose a standard value as a minimum reduction weight, most of them base weight reduction minimums on body surface area or body mass index (BMI) [6,7].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Resection Weight in Reduction Mammaplasty Based on Anthropometric Measurements

Keçeci¹,

Sır²

2014

Breast Care

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Background: The aim of this study was to develop a simple, clinically useful method to accurately predict resection weight in women undergoing reduction mammaplasty. Patients and Methods: 39 women undergoing breast reduction participated in the study. Sternal notch to nipple distance, nipple to inframammary fold distance (NIMF), medial end point to nipple distance (MN), lateral endpoint to nipple distance (LN), superior border of the breast to nipple distance (SN), breast circumference (BC), and chest circumference (CC) were measured. 5 other predicting variables were also derived; horizontal breast measurement (H) by adding MN to LN, vertical breast measurement (V) by adding NIMF to SN, the product of H and V (H*V), the product of H and NIMF (H*NIMF), and the difference between BC and CC (D). Regression analysis was used to compose a formula for predicting resection weight. Results: Among the predicting variables, H*NIMF measurements had the highest correlation coefficient value (Pearson correlation = 0.809) with the resection weight. The following formula was obtained with regression analysis: Predicted resection weight = (1.45 × H*NIMF) + (31.5 × D) - 576. Conclusion: Breast resection weights can be accurately predicted by the presented method based on anthropomorphic measurements.

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Reduction Mammaplasty: Cosmetic or Reconstructive Procedure?

Cited by 87 publications

References 0 publications

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

The Outcome of Reduction Mammaplasty is Affected More by Psychosocial Factors Than by Changes in Breast Dimensions

Prediction of Resection Weight in Reduction Mammaplasty Based on Anthropometric Measurements

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