Effects of Reduction Mammaplasty on Pulmonary Function and Symptoms of Macromastia

Abstract

A number of studies have documented subjective improvement in somatic and psychological symptoms following breast reduction surgery. Objective data demonstrating improved postoperative function have been more difficult to assess, and particularly with respect to pulmonary function, the results have been contradictory. In this prospective study, patients completed a comprehensive preoperative questionnaire modified from the American Thoracic Society Division of Lung Diseases Epidemiology Standardization Project (1978). This questionnaire noted subjective pulmonary symptoms and pulmonary medical history. In addition, subjective symptoms related to breast size, including back and neck pain and shoulder pain and grooving, and a subjective evaluation of body image, were evaluated. All subjects received preoperative pulmonary function testing, including spirometry, lung volume measurements, and measurement of peak inspiratory and expiratory flow rates and pressures. Eight weeks after breast reduction, a repeat questionnaire and pulmonary function testing were administered. Preoperative and postoperative pulmonary function values were compared using Cochran-Mantel-Haenszel tests, and correlations were tested between changes in pulmonary function test values and subjective symptom improvement. Forty-four patients underwent an average of 2228-g bilateral reduction. All of these patients had their surgical procedures preauthorized as medically necessary by their insurance carriers. All subjective parameters examined were statistically significantly improved following breast reduction (p < 0.001). Of the 17 patients with preoperative complaints of shortness of breath, all noted significant improvement following breast reduction surgery (p < 0.001). Of the objective pulmonary criteria evaluated, inspiratory capacity, peak expiratory flow rate, and maximal voluntary ventilation showed a statistically significant improvement following surgery (p < 0.05). These changes correlated with body mass index; the greater the index, the greater the change in maximal voluntary ventilation and peak expiratory flow rate. Smokers in this group had the largest change in maximal voluntary ventilation (p < 0.008). No correlation could be found between preoperative pulmonary symptoms, a single subjective symptom, or grams of breast weight reduction and changes in pulmonary function tests. The results show that pulmonary parameters, related primarily to work of breathing (inspiratory capacity, maximal voluntary ventilation, peak expiratory flow rate), were statistically improved following breast reduction surgery, and these changes correlated with body mass index.

Effects of Breast Size on Lung Function

“…The authors commented that there was an overall improvement in chest wall compliance and total compliance following breast reduction surgery. The mean weight of excised breast tissue in their study was 1546 g. Sood et al 4 demonstrated an improvement in inspiratory capacity, peak expiratory flow rate, and maximal voluntary ventilation. This also correlated positively with BMI; the more obese the patient was, the more the improvement there was in pulmonary function.…”

“…A few previous studies regarding the effect of reduction mammaplasty on pulmonary function tests reported improvements in PFTs after reduction mammaplasty, in the other hand some others reported contradictory results (1)(2)(3)(4)(5). Therefore, BMI may be the key linking whether a reduction mammmaplasty may affect PFTs, so it is worthwhile to investigate the relationship between bra cup size, BMI and PFTs in normal adult females.…”

Avaliação da função pulmonar em pacientes submetidas à mastoplastia redutora

“…In 2003, Sood et al 3 found statistically significant improvement in spirometry in the parameters inspiratory capacity, peak expiratory flow and maximal voluntary ventilation (2,220g of mean weight of resected breast). These parameters were also positively correlated with body mass index: the more obese the patients, the better the parameters of lung function.…”

“…The lung function has been studied in patients undergoing reduction mammaplasty, however, few studies have evaluated objective data 3,7,8 . This can be done through lung function tests and measurement of arterial blood gases.…”

“…There are several associated symptoms in the breast and musculoskeletal system (back, shoulder and cervical spine) 1,2 . Several retrospective and prospective studies have documented statistically significant improvement in symptoms and quality of life of patients who underwent reduction mammaplasty [3][4][5][6] . Despite this documentation, it has been considered a more aesthetic than strictly medical procedure.…”