Reduction mammoplasty and back pain: a systematic review and meta-analysis

Abstract

Purpose There is anecdotal evidence that many patients who undergo reduction mammoplasty (RM) procedures, to relieve symptoms of large breasts, also report improvement in existing back pain. Given how important back pain is as a healthcare burden, the literature which explores the relationship between RM and back pain is sparse. Thus, we aimed to appraise whether such a correlation exists, through systematic review and meta-analysis. Method Adhering to PRISMA methodology, we used the OVID engine to search the MEDLINE and Embase databases with predefined search terms and inclusion criteria. MeSH terms were not exploded. Statistical analysis was performed using Review Manager 5.3, employing a Mantell-Haenszel method and a fixed-effect model suitable for dichotomous data. Results The review yielded 13 articles after exclusions, eight of which were suitable for quantitative analysis. The results of the analysis suggested an improvement in back pain following RM across all studies (OR 40.37 [8.09, 201.53] 95% CI, n = 1008). Heterogeneity was high (τ 2 = 5.14, χ 2 = 230.37, df = 7 (p < 0.00001) i 2 = 97%). Conclusions Although cursory, the evidence gleaned suggests that RM reduces the prevalence of back pain in patients with large breasts. Furthermore, we highlight the scarcity of studies investigating whether RM is at the clinical threshold of efficacy in treating back pain. Although the evidence is insufficient for recommending RM as a management option aimed at treating back pain, this review does identify the need for prospective data looking at back pain metrics as a specific outcome measure before and after reduction mammoplasty.

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

“…The combination of removing breast fat, glandular tissue, and skin allows the surgeon to decrease breast weight and restructure the breast to a more pleasing appearance 1 . The indications for reduction mammaplasty include aesthetic concerns and therapeutic reasons such as decrease of breast weight for treatment of complaints of breast and skeletal pain (mainly back and neck pain), 2,3 ptosis, intertriginous skin disorders of the inter‐ or sub‐mammary fold, and psychological disorders 4,5 . When performed for therapeutic reasons, bilateral reduction mammaplasty is one of the few plastic surgeries that health insurance providers in many countries will recognise and routinely pay for 6,7 …”

Evaluation of the Effect of Reduction Mammoplasty on Body Posture in Patients with Macromastia

“…Some studies have shown significant alleviation of pain after the reduction of mammoplasty [ 17 ]. The obtained results also showed a significant reduction in the neck, shoulder, and back pain after operation in patients with pre-op BMI>30.…”

Postoperative Health-related Quality of Life in Reduction Mammaplasty

“…The findings resulted from this study consistent with previous reviews of this subject and are supported by other publications with other outcomes that are not mentioned in this review. Mian et al 25 have also found that breast reduction reduces the prevalence of back pain in women with large breasts. That is because breast hypertrophy deranges the spinal angles relating to thoracic kyphosis, lumbar lordosis, and the correct alignment of the sacrum, 40,41 and breast tissue resection could improve this pathological status quo.…”

“…Many researchers have studied the relationship between operation and postoperative quality of life. Mian et al 25 have reported that reduction mammaplasty reduces the prevalence of back pain in patients with breast hypertrophy. Some authors have concluded that operation has a positive impact on women's sexual function, sexual quality of life, and sexual well-being 11,26 .…”