Breast Reduction Surgery- Is It Worth It?

I have patients argue that the reduction of upper back pain would be an indication for breast reduction. What needs to be factored in, is the 11-49% chronic scar pain following surgery – and how to deal with that.

Breast reduction surgery can have benefits with “Most patients (97%) had improvement of symptoms, and 59% were asymptomatic”

from:
Reduction Mammaplasty: An Outcome Analysis
Annals of Plastic Surgery  October 1995 – Volume 35 – Issue 4  abstract here

However, it appears one is in a lottery – scar pains are not uncommon:

BMJ. 2010 Nov 16;341:c6510.
Request for breast reduction. Don’t forget chronic scar pain.
Vemmer T

Warns that breast reduction is not necessarily a benign procedure as chronic scar pain is a very real possibility and ranges from 11-49%.

Comment – so when can someone have it? – Younger the better – their painkilling modulating circuits will still function and  the pain rates would be significantly less. Had a relative have it in her 20’s without any problem.  Older cases unfortunately in a lottery re scar pains.

Addendum:

I stand corrected – a review of Mammoplasty effects:

Plast Reconstr Surg. 2011 Nov 15. [Epub ahead of print]
Additional Benefits to Reduction Mammaplasty: A Systemic Review of the Literature.
Singh KA, Losken A. Emory Division of Plastic and Reconstructive Surgery.  abstract here

INTODUCTION:: Reduction mammaplasty (RM) is commonly described with regard to its qualitative benefits. We sought to perform a systemic review of the literature
focusing on functional outcomes after RM with regard to physical and psychological symptom improvement, including weight related effects, exercise, and eating behaviors, as well as aesthetic outcomes.
METHODS:: A systematic review of the English literature was performed using PUBMED to evaluate outcomes  following RM from 1977-2010. Studies were chosen that addressed the physical and psychological benefits of RM using a validated questionnaire.
RESULTS:: Women who undergo RM have a functional improvement in musculoskeletal pain, headaches, leep, and breathing. Psychological benefits are vast and include improved self
esteem, sexual function, and quality of life, as well as less anxiety and depression. Following RM, women appear to exercise more and have a reduction in eating disorders.
CONCLUSIONS:: We present a comprehensive review of the literature with regard to the physical and emotional concerns women with macromastia experience, and the broad benefits reduction mammaplasty could have on their daily functions, and quality of life postoperatively.

Looks like conclusions of review are definitely positive….

addendum:

Can J Plast Surg. 2013 Spring;21(1):29-32.

Reduction mammoplasty improves body posture and decreases the perception of pain.

Goulart R Jr1, Detanico D2, Vasconcellos RP2, Schütz GR2, Dos Santos SG2.

Author information

Abstract

in English, French

 

Women with hypertrophic breasts often experience body pain and posture problems, which tend to be reduced or even eliminated after reduction mammoplasty. The present study aimed to analyze the effects of reduction mammoplasty on anthropometric variables, body posture and pain in women with breast hypertrophy. Eleven women (mean [± SD] age 31.3±10.4 years) participated in the present study. Anthropometric variables, body posture and pain perception were evaluated pretest, and 60 (post60) and 90 (post90) days after reduction mammoplasty. Commercially available posture analysis software was used to analyze the following variables: acromial horizontal alignment (AHA), angle between acromial and anterior superior iliac spines (A-AAIS), vertical alignment of right (R) and left (L) trunk (VAT), vertical alignment of R and L body (VAB) and horizontal alignment of R and L pelvis (HAP). Descriptive statistics and ANOVA for repeated measures were used, and effect sizes (ES) were measured; the level of significance was set at P<0.05. There were no significant differences in anthropometric variables among the assessments. Only HAP-R showed a significant decrease; however, when analyzed, ES, VAT- L and HAP- L in post60, and VAT-R, VAT-L, HAP-R, HAP-L and VAB-L in post90 showed large ES after mammoplasty (ES>0.70). There were significant reductions in pain at post60 and post90 in the neck, cervical spine, back, shoulder and arm (P<0.05). Following mammoplasty, an improvement in body posture, primarily in the alignment of shoulders, trunk and pelvis, and a decrease in pain in the upper limbs and spine, were observed.

 

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