Complications and Quality of Life following Reduction Mammaplasty in Adolescents and Young Women

Abstract

Background: Adolescent reduction mammaplasty remains controversial because of concerns of postoperative breast growth, complications, and the effect on well-being. The authors sought to prospectively quantify early and late complications following reduction mammaplasty in adolescents and young women, and examine the intersection of surgical complications and postoperative health-related quality of life. Methods: From 2008 to 2017, female patients aged 12 to 21 years undergoing reduction mammaplasty were asked to complete the 36-Item Short-Form Health Survey (version 2), the Rosenberg Self-Esteem Scale, the Breast-Related Symptoms Questionnaire, and the Eating-Attitudes Test-26 preoperatively and postoperatively at 6 months and 1, 3, 5, and 7 years. Clinical evaluations using standardized forms assessed baseline and postoperative symptomatology, complications, and surgical outcomes. Results: In the authors’ sample of 512 participants, the most common complications included hypertrophic scarring (20.0 percent) and altered sensation of the nipple (8.4 percent) or breast (7.8 percent). Patient age, body mass index category, and amount of tissue resected did not significantly increase the odds of developing a complication. Significant postoperative improvements on the Rosenberg Self-Esteem Scale, the Breast-Related Symptoms Questionnaire, the Eating-Attitudes Test-26, and in all 36-Item Short-Form Health Survey domains (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health) were largely seen irrespective of whether complications occurred. Conclusions: Although complications following reduction mammaplasty were common, the vast majority were minor. Patients had significant postoperative improvements in their physical and psychosocial well-being regardless of whether they experienced a complication. Concerns for potential complication, especially in younger and overweight or obese patients, should not preclude otherwise healthy adolescents and young women from the benefits of reduction mammaplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Twenty Years of Breast Reduction Surgery at a Veterans Affairs Medical Center

“…There are several known complications specific to this operation that include asymmetry, changes in nipple sensation, unattractive scars, diminished ability to breastfeed, and wound complications. [5][6][7] Wound complications include seroma, hematoma, dehiscence, infection, wound breakdown, skin necrosis, and nipple necrosis.…”

“…For the treatment of symptomatic macromastia, patients report a high satisfaction rate after breast reduction surgery. [3][4][5] Unfortunately, the complications from the surgery can significantly disrupt a woman' s life due to previously unplanned hospital admissions, clinic appointments, wound care, time off work, and poor aesthetic outcome. Fac-ulty awareness of a large number of complications for patients after breast reduction surgery prompted the MRVAMC Plastic Surgery Service to establish a stricter surgical screening protocol using body mass index (BMI) values and negative nicotine status to help patients be healthier and reduce the potential risk before offering surgery.…”

Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

“…16 Moreover, Krucoff et al and Nuzzi et al found RM patients especially young women experience excellent breast-related QoL with high satisfaction with breasts and sexual wellbeing. 17,18 Crittenden et al reported statistically significant improvements in satisfaction with breasts, psychosocial well-being, sexual well-being and physical well-being scorings of patients with breast hypertrophy after RM in comparison to preoperative scores. 19 Recently, Silhol et al reported an inverse correlation between breast volume and sensibility in the preoperative evaluation, but disappeared after RM and Lin et al found the QoL of women underwent RM is significantly improved with special regard to pain, physical function and psychological function, and concluded that RM is an effective treatment for symptomatic breast hypertrophy.…”

Does large breast problem and macromastıa surgery affect a woman's body image, depressıon level, sexual lıfe, and qualıty of lıfe? A prospectıve study

“…Young women and adolescents, for whom body perception is more important, are more inclined to showing depressive symptoms. It is suggested that breast hypertrophy problem affects the bilateral relations or social relations negatively as a result of serious mental exposures in young women and adolescents 5,6,12 . Indeed, it is indicated that breast hypertrophy problem leads to risk in some adolescents such as eating disorder, bulimia nervosa, obesity, intentional vomiting, laxative and diuretic drugs, and suicidal thought 1,8,12,25 .…”

“…Although the presence of factors such as genetic predisposition and oversensitivity to estrogen is mentioned in the etiology of breast hypertrophy, this issue remains a mystery 2 . Breast hypertrophy is a disease that is encountered frequently in clinics, affects women's life multidimensionally, impairs the quality of life, and has mentally, physically, and socially negative effects [1][2][3][4][5][6] .…”