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Published in: Archives of Gynecology and Obstetrics 4/2013

01-04-2013 | General Gynecology

Reduction mammaplasty for symptomatic macromastia: which factors influence the post-operative outcome?

Authors: Julia C. Radosa, Marc P. Radosa, Sascha Baum, Russalina Mavrova, Oumar Camara

Published in: Archives of Gynecology and Obstetrics | Issue 4/2013

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Abstract

Purpose

We evaluated the long-term results and patient’s satisfaction in reduction mammaplasties for symptomatic mammary hypertrophy.

Methods

From 2002 to 2008 a total of 92 women underwent bilateral mammaplasty for a symptomatic macromastia at our department. Three different surgical techniques for reduction mammaplasty were used (Bostwick, Stroembeck, Ribeiro). Patients were re-contacted in 2009 and asked to complete a self-assessment survey in order to asses their satisfaction with the post-operative symptom-relief and the overall outcome.

Results

90.5 % of all patients stated, that they would retrospectively re-opt for a reduction mammaplasty. Preoperative patients' age, BMI and severity of macromasty-related symptoms were found to be factors positively correlated with a high post-interventional satisfaction with the achieved symptom-relief and the overall outcome. No correlation was found between the amount of intra-operatively resected breast tissue and the post-operative patients’ assessment. Patients’ assessment regarding the achieved post-operative symptom relief was comparable for all three surgical techniques, however the overall outcome rating for both bi-pedicled approaches (Stroembeck and Ribeiro) was higher compared to the mono-pedicled Bostwick technique.

Conclusions

Reduction mammaplasty for patients with a mammary hypertrophy and somatic symptoms could offer a causal and effective treatment. The predictive factors for a high patients’ satisfaction identified in this study could become a valuable tool in the pre-operative patients counceling and their role should be further evaluated prospectively. The use of bi-pedicled surgical techniques seems to favor a high post-operative patients’ assessment.
Literature
1.
go back to reference Letterman G, Schurter M (1980) The effects of mammary hypertrophy on the skeletal system. Ann Plast Surg 5(6):425–431PubMedCrossRef Letterman G, Schurter M (1980) The effects of mammary hypertrophy on the skeletal system. Ann Plast Surg 5(6):425–431PubMedCrossRef
2.
3.
go back to reference Kerrigan CL, Collins ED, Striplin D, Kim HM, Wilkins E, Cunningham B, Lowery J (2001) The health burden of breast hypertrophy. Plast Reconstr Surg 108(6):1591–1599PubMedCrossRef Kerrigan CL, Collins ED, Striplin D, Kim HM, Wilkins E, Cunningham B, Lowery J (2001) The health burden of breast hypertrophy. Plast Reconstr Surg 108(6):1591–1599PubMedCrossRef
4.
go back to reference Mello AA, Domingos NA, Miyazaki MC (2010) Improvement in quality of life and self-esteem after breast reduction surgery. Aesthetic Plast Surg 34(1):59–64PubMedCrossRef Mello AA, Domingos NA, Miyazaki MC (2010) Improvement in quality of life and self-esteem after breast reduction surgery. Aesthetic Plast Surg 34(1):59–64PubMedCrossRef
5.
go back to reference Andrades P, Prado A (2008) Understanding modern breast reduction techniques with a simplified approach. J Plast Reconstr Aesthet Surg 61(11):1284–1293PubMedCrossRef Andrades P, Prado A (2008) Understanding modern breast reduction techniques with a simplified approach. J Plast Reconstr Aesthet Surg 61(11):1284–1293PubMedCrossRef
6.
go back to reference Foreman KB, Dibble LE, Droge J, Carson R, Rockwell WB (2009) The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia. Plast Reconstr Surg 124(5):1393–1399PubMedCrossRef Foreman KB, Dibble LE, Droge J, Carson R, Rockwell WB (2009) The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia. Plast Reconstr Surg 124(5):1393–1399PubMedCrossRef
7.
go back to reference Sabino Neto M, Demattê MF, Freire M, Garcia EB, Quaresma M, Ferreira LM (2008) Self-esteem and functional capacity outcomes following reduction mammaplasty. Aesthet Surg J 28(4):417–420PubMedCrossRef Sabino Neto M, Demattê MF, Freire M, Garcia EB, Quaresma M, Ferreira LM (2008) Self-esteem and functional capacity outcomes following reduction mammaplasty. Aesthet Surg J 28(4):417–420PubMedCrossRef
8.
go back to reference Saariniemi KM, Keranen UH, Salminen-Peltola PK, Kuokkanen HO (2008) Reduction mammaplasty is effective treatment according to two quality of life instruments. A prospective randomised clinical trial. J Plast Reconstr Aesthet Surg 61(12):1472–1478PubMedCrossRef Saariniemi KM, Keranen UH, Salminen-Peltola PK, Kuokkanen HO (2008) Reduction mammaplasty is effective treatment according to two quality of life instruments. A prospective randomised clinical trial. J Plast Reconstr Aesthet Surg 61(12):1472–1478PubMedCrossRef
9.
go back to reference Bostwick J 3rd (1998) Plastic and reconstructive breast surgery. Quality Medical Publishing, New York Bostwick J 3rd (1998) Plastic and reconstructive breast surgery. Quality Medical Publishing, New York
10.
go back to reference Strombeck JO (1964) Breast reconstruction. I. Reduction mammaplasty. Mod Trends Plast Surg 16:237–255PubMed Strombeck JO (1964) Breast reconstruction. I. Reduction mammaplasty. Mod Trends Plast Surg 16:237–255PubMed
11.
go back to reference Ribeiro L (1975) A new technique for reduction mammaplasty. Plast Reconstr Surg 55(3):330–334PubMed Ribeiro L (1975) A new technique for reduction mammaplasty. Plast Reconstr Surg 55(3):330–334PubMed
12.
go back to reference Lista F, Ahmad J (2006) Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases. Plast Reconstr Surg 117(7):2152–2165, 2166–2169 Lista F, Ahmad J (2006) Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases. Plast Reconstr Surg 117(7):2152–2165, 2166–2169
13.
go back to reference Godwin Y, Wood SH, O’Neill TJ (1998) A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty. Br J Plast Surg 51(6):444–449PubMedCrossRef Godwin Y, Wood SH, O’Neill TJ (1998) A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty. Br J Plast Surg 51(6):444–449PubMedCrossRef
14.
go back to reference Ramon Y, Sharony Z, Moscona RA, Ullmann Y, Peled IJ (2000) Evaluation and comparison of aesthetic results and patient satisfaction with bilateral breast reduction using the inferior pedicle and McKissock’s vertical bipedicle dermal flap techniques. Plast Reconstr Surg 106(2):289–95, 295–297 Ramon Y, Sharony Z, Moscona RA, Ullmann Y, Peled IJ (2000) Evaluation and comparison of aesthetic results and patient satisfaction with bilateral breast reduction using the inferior pedicle and McKissock’s vertical bipedicle dermal flap techniques. Plast Reconstr Surg 106(2):289–95, 295–297
15.
go back to reference Glatt BS, Sarwer DB, O’Hara DE, Hamori C, Bucky LP, LaRossa D (1999) A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg 103(1):76–82, 83–85 Glatt BS, Sarwer DB, O’Hara DE, Hamori C, Bucky LP, LaRossa D (1999) A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg 103(1):76–82, 83–85
16.
go back to reference Chao JD, Memmel HC, Redding JF, Egan L, Odom LC, Casas LA (2002) Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg 110(7):1644–1652, 1653–1654 Chao JD, Memmel HC, Redding JF, Egan L, Odom LC, Casas LA (2002) Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg 110(7):1644–1652, 1653–1654
17.
go back to reference Schnur PL, Schnur DP, Petty PM, Hanson TJ, Weaver AL (1997) Reduction mammaplasty: an outcome study. Plast Reconstr Surg 100(4):875–883PubMed Schnur PL, Schnur DP, Petty PM, Hanson TJ, Weaver AL (1997) Reduction mammaplasty: an outcome study. Plast Reconstr Surg 100(4):875–883PubMed
18.
go back to reference Menderes A, Mola F, Vayvada H, Barutcu A (2005) Evaluation of results from reduction mammaplasty: relief of symptoms and patient satisfaction. Aesthetic Plast Surg 29(2):83–87PubMedCrossRef Menderes A, Mola F, Vayvada H, Barutcu A (2005) Evaluation of results from reduction mammaplasty: relief of symptoms and patient satisfaction. Aesthetic Plast Surg 29(2):83–87PubMedCrossRef
19.
go back to reference Makki AS, Ghanem AA (1998) Long-term results and patient satisfaction with reduction mammaplasty. Ann Plast Surg 41(4):370–377PubMedCrossRef Makki AS, Ghanem AA (1998) Long-term results and patient satisfaction with reduction mammaplasty. Ann Plast Surg 41(4):370–377PubMedCrossRef
20.
go back to reference Collins ED, Kerrigan CL, Kim M, Lowery JC, Striplin DT, Cunningham B, Wilkins EG (2002) The effectiveness of surgical and nonsurgical interventions in relieving the symptoms of macromastia. Plast Reconstr Surg 109(5):1556–1566PubMedCrossRef Collins ED, Kerrigan CL, Kim M, Lowery JC, Striplin DT, Cunningham B, Wilkins EG (2002) The effectiveness of surgical and nonsurgical interventions in relieving the symptoms of macromastia. Plast Reconstr Surg 109(5):1556–1566PubMedCrossRef
21.
go back to reference Harbo SO, Jørum E, Roald HE (2003) Reduction mammaplasty: a prospective study of symptom relief and alterations of skin sensibility. Plast Reconstr Surg 111(1):103–10, 111–112 Harbo SO, Jørum E, Roald HE (2003) Reduction mammaplasty: a prospective study of symptom relief and alterations of skin sensibility. Plast Reconstr Surg 111(1):103–10, 111–112
22.
go back to reference Lejour M (1999) Vertical mammaplasty: early complications after 250 personal consecutive cases. Plast Reconstr Surg 104(3):764–770PubMed Lejour M (1999) Vertical mammaplasty: early complications after 250 personal consecutive cases. Plast Reconstr Surg 104(3):764–770PubMed
23.
go back to reference O’Grady KF, Thoma A, Dal Cin A (2005) A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg 115(3):736–742PubMedCrossRef O’Grady KF, Thoma A, Dal Cin A (2005) A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg 115(3):736–742PubMedCrossRef
24.
go back to reference Stevens WG, Gear AJ, Stoker DA, Hirsch EM, Cohen R, Spring M, Vath SD, Schantz SA, Heck RT (2008) Outpatient reduction mammaplasty: an eleven-year experience. Aesthet Surg J 28(2):171–179PubMedCrossRef Stevens WG, Gear AJ, Stoker DA, Hirsch EM, Cohen R, Spring M, Vath SD, Schantz SA, Heck RT (2008) Outpatient reduction mammaplasty: an eleven-year experience. Aesthet Surg J 28(2):171–179PubMedCrossRef
25.
go back to reference Freire M, Neto MS, Garcia EB, Quaresma MR, Ferreira LM (2007) Functional capacity and postural pain outcomes after reduction mammaplasty. Plast Reconstr Surg 119(4):1149–1156, 1157–1158 Freire M, Neto MS, Garcia EB, Quaresma MR, Ferreira LM (2007) Functional capacity and postural pain outcomes after reduction mammaplasty. Plast Reconstr Surg 119(4):1149–1156, 1157–1158
26.
go back to reference Miller AP, Zacher JB, Berggren RB, Falcone RE, Monk J (1995) Breast reduction for symptomatic macromastia: can objective predictors for operative success be identified? Plast Reconstr Surg 95(1):77–83PubMedCrossRef Miller AP, Zacher JB, Berggren RB, Falcone RE, Monk J (1995) Breast reduction for symptomatic macromastia: can objective predictors for operative success be identified? Plast Reconstr Surg 95(1):77–83PubMedCrossRef
27.
go back to reference Tüzün C, Yorulmaz I, Cindaş A, Vatan S (1999) Low back pain and posture. Clin Rheumatol 18(4):308–312PubMedCrossRef Tüzün C, Yorulmaz I, Cindaş A, Vatan S (1999) Low back pain and posture. Clin Rheumatol 18(4):308–312PubMedCrossRef
28.
go back to reference Fouquet B, Goupille P, Rouif M, Rouif V, Mateu J, Valat JP (1991) Breast hypertrophy and dorsolumbar spine. Prognostic influences of lumbar lordosis: preliminary results. Rev Rhum Mal Osteoartic 58(6):453–457PubMed Fouquet B, Goupille P, Rouif M, Rouif V, Mateu J, Valat JP (1991) Breast hypertrophy and dorsolumbar spine. Prognostic influences of lumbar lordosis: preliminary results. Rev Rhum Mal Osteoartic 58(6):453–457PubMed
29.
go back to reference Sommer NZ, Zook EG, Verhulst SJ (2002) The prediction of breast reduction weight. Plast Reconstr Surg 109(2):506–511PubMedCrossRef Sommer NZ, Zook EG, Verhulst SJ (2002) The prediction of breast reduction weight. Plast Reconstr Surg 109(2):506–511PubMedCrossRef
30.
go back to reference Wagner DS, Alfonso DR (2005) The influence of obesity and volume of resection on success in reduction mammaplasty: an outcomes study. Plast Reconstr Surg 115(4):1034–1038PubMedCrossRef Wagner DS, Alfonso DR (2005) The influence of obesity and volume of resection on success in reduction mammaplasty: an outcomes study. Plast Reconstr Surg 115(4):1034–1038PubMedCrossRef
31.
go back to reference Rohrich RJ, Gosman AA, Brown SA, Tonadapu P, Foster B (2004) Current preferences for breast reduction techniques: a survey of board-certified plastic surgeons 2002. Plast Reconstr Surg 114(7):1724–1733, 1734–1736 Rohrich RJ, Gosman AA, Brown SA, Tonadapu P, Foster B (2004) Current preferences for breast reduction techniques: a survey of board-certified plastic surgeons 2002. Plast Reconstr Surg 114(7):1724–1733, 1734–1736
32.
go back to reference Hidalgo DA, Elliot LF, Palumbo S, Casas L, Hammond D (1999) Current trends in breast reduction. Plast Reconstr Surg 104(3):806–815PubMed Hidalgo DA, Elliot LF, Palumbo S, Casas L, Hammond D (1999) Current trends in breast reduction. Plast Reconstr Surg 104(3):806–815PubMed
33.
go back to reference Spector JA, Karp NS (2007) Reduction mammaplasty: a significant improvement at any size. Plast Reconstr Surg 120(4):845–850PubMedCrossRef Spector JA, Karp NS (2007) Reduction mammaplasty: a significant improvement at any size. Plast Reconstr Surg 120(4):845–850PubMedCrossRef
34.
go back to reference Spector JA, Singh SP, Karp NS (2008) Outcomes after breast reduction: does size really matter? Ann Plast Surg 60(5):505–509PubMedCrossRef Spector JA, Singh SP, Karp NS (2008) Outcomes after breast reduction: does size really matter? Ann Plast Surg 60(5):505–509PubMedCrossRef
35.
go back to reference Hermans BJ, Boeckx WD, De Lorenzi F, van der Hulst RR (2005) Quality of life after breast reduction. Ann Plast Surg 55(3):227–231PubMedCrossRef Hermans BJ, Boeckx WD, De Lorenzi F, van der Hulst RR (2005) Quality of life after breast reduction. Ann Plast Surg 55(3):227–231PubMedCrossRef
36.
go back to reference Nahabedian MY (2005) Scar wars: optimizing outcomes with reduction mammaplasty. Plast Reconstr Surg 116(7):2026–2029PubMedCrossRef Nahabedian MY (2005) Scar wars: optimizing outcomes with reduction mammaplasty. Plast Reconstr Surg 116(7):2026–2029PubMedCrossRef
37.
go back to reference Hester TR Jr, Bostwick J 3rd, Miller L, Cunningham SJ (1985) Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg 76(6):890–900PubMedCrossRef Hester TR Jr, Bostwick J 3rd, Miller L, Cunningham SJ (1985) Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg 76(6):890–900PubMedCrossRef
38.
go back to reference Deutinger M, Deutinger J (1993) Breast feeding after aesthetic mammary operations and cardiac operations through horizontal submammary skin incision. Surg Gynecol Obstet 176(3):267–270PubMed Deutinger M, Deutinger J (1993) Breast feeding after aesthetic mammary operations and cardiac operations through horizontal submammary skin incision. Surg Gynecol Obstet 176(3):267–270PubMed
39.
go back to reference Faridi A (2009) Options for breast reduction surgery. J Aesthet Chir 2:84–93 Faridi A (2009) Options for breast reduction surgery. J Aesthet Chir 2:84–93
40.
go back to reference Strömbeck JO (1983) Reduction mammoplasty: some observations and reflections. Aesthetic Plast Surg 7(4):249–251PubMedCrossRef Strömbeck JO (1983) Reduction mammoplasty: some observations and reflections. Aesthetic Plast Surg 7(4):249–251PubMedCrossRef
41.
go back to reference Ribeiro L, Accorsi A Jr, Buss A, Marcal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110(3):960–970PubMedCrossRef Ribeiro L, Accorsi A Jr, Buss A, Marcal-Pessoa M (2002) Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 110(3):960–970PubMedCrossRef
42.
go back to reference Lee TJ, Eom JS (1999) Periareolar reduction mammaplasty utilizing the inferior dermal pedicle. Aesthetic Plast Surg 23(5):331–336PubMedCrossRef Lee TJ, Eom JS (1999) Periareolar reduction mammaplasty utilizing the inferior dermal pedicle. Aesthetic Plast Surg 23(5):331–336PubMedCrossRef
43.
go back to reference Reavey PL, Klassen AF, Cano SJ, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL (2011) Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J 31(7):807–813PubMedCrossRef Reavey PL, Klassen AF, Cano SJ, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL (2011) Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J 31(7):807–813PubMedCrossRef
44.
go back to reference Coriddi M, Koltz PF, Gusenoff JA (2011) Reduction mammaplasty, obesity, and massive weight loss: temporal relationships of satisfaction with breast contour. Plast Reconstr Surg 128(3):643–650PubMedCrossRef Coriddi M, Koltz PF, Gusenoff JA (2011) Reduction mammaplasty, obesity, and massive weight loss: temporal relationships of satisfaction with breast contour. Plast Reconstr Surg 128(3):643–650PubMedCrossRef
45.
go back to reference Rodríguez MC, Chedraui P, Schwager G, Hidalgo L, Pérez-López FR (2012) Assessment of sexuality after hysterectomy using the Female Sexual Function Index. J Obstet Gynaecol 32(2):180–184PubMedCrossRef Rodríguez MC, Chedraui P, Schwager G, Hidalgo L, Pérez-López FR (2012) Assessment of sexuality after hysterectomy using the Female Sexual Function Index. J Obstet Gynaecol 32(2):180–184PubMedCrossRef
Metadata
Title
Reduction mammaplasty for symptomatic macromastia: which factors influence the post-operative outcome?
Authors
Julia C. Radosa
Marc P. Radosa
Sascha Baum
Russalina Mavrova
Oumar Camara
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 4/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2620-z

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