The Influence of Obesity and Volume of Resection on Success in Reduction Mammaplasty: An Outcomes Study

Wagner, David J.; Alfonso, David R.

doi:10.1097/01.prs.0000154213.06888.f9

Cited by 103 publications

(58 citation statements)

References 3 publications

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“…[50][51][52] Our results confirm this observation with high rates of overweight (35%) and obesity (35%) in our subjects with macromastia. Thus, we controlled for BMI category.…”

Section: Discussionsupporting

confidence: 80%

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

Cerrato

Webb²,

Rosen³

et al. 2012

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Macromastia is associated with severe physical and emotional symptoms and negatively impacts health-related quality of life in adult women. Reduction mammaplasty is the most effective treatment for adults. Little is known regarding the impact of macromastia during adolescence.WHAT THIS STUDY ADDS: Adolescents with macromastia have impaired health-related quality of life, lower self-esteem, more breastrelated symptoms, and are at higher risk for disordered eating in comparison with their peers. These negative health outcomes have implications for early intervention in this patient population. abstract OBJECTIVE: To determine the physical and psychosocial impact of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents. METHODS:The following surveys were administered to adolescents with macromastia and control subjects, aged 12 to 21 years: ShortForm 36v2, Rosenberg Self-Esteem Scale, Breast-Related Symptoms Questionnaire, and Eating-Attitudes Test-26 (EAT-26). Demographic variables and self-reported breast symptoms were compared between the 2 groups. Linear regression models, unadjusted and adjusted for BMI category (normal weight, overweight, obese), were fit to determine the effect of case status on survey score. Odds ratios for the risk of disordered eating behaviors (EAT-26 score $20) in cases versus controls were also determined. RESULTS:Ninety-six subjects with macromastia and 103 control subjects participated in this study. Age was similar between groups, but subjects with macromastia had a higher BMI (P = .02). Adolescents with macromastia had lower Short-Form 36v2 domain, Rosenberg Self-Esteem Scale, and Breast-Related Symptoms Questionnaire scores and higher EAT-26 scores compared with controls. Macromastia was also associated with a higher risk of disordered eating behaviors. In almost all cases, the impact of macromastia was independent of BMI category.CONCLUSIONS: Macromastia has a substantial negative impact on health-related quality of life, self-esteem, physical symptoms, and eating behaviors in adolescents with this condition. These observations were largely independent of BMI category. Health care providers should be aware of these important negative health outcomes that are associated with macromastia and consider early evaluation for adolescents with this condition. Pediatrics 2012;130:e339-e346 AUTHORS:

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“…[50][51][52] Our results confirm this observation with high rates of overweight (35%) and obesity (35%) in our subjects with macromastia. Thus, we controlled for BMI category.…”

Section: Discussionsupporting

confidence: 80%

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

Cerrato

Webb²,

Rosen³

et al. 2012

Pediatrics

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“…By doing so, we found the preoperative ptotic breast mass was significantly correlated to the resectional breast mass, while alleviating breast weight-related symptoms, achieving a pleasing breast shape, and avoiding over-or under-resection. Breast reduction can also be beneficial in the obese patient (10,11), and this technique proved to be statistically significant in the obese women (body mass index greater than 30 kg/m 2 ) in our study.…”

Section: Discussionmentioning

confidence: 73%

Predicting breast reduction weight using the mass of breast ptosis

Murray¹,

Elwood²

2008

Plastic Surgery

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JD Murray, ET Elwood, R Barrick, J Feng. Predicting breast reduction weight using the mass of breast ptosis. Can J Plast Surg 2008;16(1):18-22.BACKGROUND: The preoperative prediction of therapeutic breast reduction weights, to achieve both relief of breast weight symptoms and yet achieve excellent breast shape, remains a challenge. OBJECTIVES: To design a simple clinical method to preoperatively predict and quantify therapeutic breast reduction weights. METHODS: In 31 women who underwent therapeutic bilateral reduction mammaplasty, the mass of the hypertrophic breast hanging below the inframammary fold was preoperatively weighed and then compared with the mass of the reduction specimen. Thirty patients underwent breast reduction using a superomedial nipple-areolar pedicle. Postoperative breast weight-related symptoms and breast shape findings were then noted. Statistical analysis relied on mean, SD, sample size, Mann-Whitney test for medians, Levene's test for variances and regression analysis. RESULTS: The average clinical follow-up was 160 days, with all patients achieving satisfactory breast size and shape from both the patient and surgeon's perspectives. All patients reported improvement of back pain, shoulder pain and lower neck pain. Two breasts developed delayed healing of the lateral skin flap, necessitating debridement and reclosure, followed by uneventful ongoing healing. There was no significant difference in preoperative ptotic breast mass and resectional breast mass (all P>0.05). CONCLUSIONS: Simple preoperative weighing of the ptotic portion of the hypertrophic breast can serve as a goal for the reduction weight, while creating pleasing breast proportions and improving breast weight-related symptoms. Preoperative quantification of the ptotic breast mass may guide the reduction technique and assist insurance precertification efforts.

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“…[16] Other studies similarly found no statistically significant difference in complication rates among the obese. [14,15,17] However, contradictory findings exist in the literature as well, supporting obesity as a risk factor. [6,[9][10][11][12][13] Chun et al [13] identified a threshold of BMI 35.6 at which postoperative complications were increased two-fold, the most common complication being infection.…”

Section: Discussionmentioning

confidence: 96%

“…Some studies associate obesity with increased postoperative complications, [9][10][11][12][13] whereas others find no statistically significant correlation. [14][15][16][17] In 2014, Nelson et al [6] studied obesity and reduction mammaplasty using the 2005-2011 American College of Surgeons -National Surgical Quality Improvement Program (ACS-NSQIP) datasets. NSQIP is a nationally-validated, risk-adjusted surgical outcomes database to measure and improve the quality of surgical care.…”

Section: Introductionmentioning

confidence: 99%

A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

Goggin¹,

Wong²,

Pruszynski³

et al. 2016

PAR

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Aim: Reduction mammaplasty is a commonly performed procedure for the treatment of symptomatic macromastia and is increasingly desired by the obese population. With the increasing prevalence obesity in the population, it is imperative to understand its effect on postoperative outcomes. The purpose of this study is to evaluate obesity as an independent risk factor for postoperative complications in breast reduction surgery using 1:1 patient matching through propensity scores between obese patients and nonobese controls. Methods: Between 2005 and 2013, the National Surgical Quality Improvement Program dataset identified a total of 6,016 patients as having undergone primary reduction mammaplasty with 30-day postoperative follow-up. Patients were divided into obese [body mass index (BMI) of 30 or more] vs. not obese (BMI below 30). Patients were initially analyzed using standard multivariable analysis. Using propensity scores obtained from a logistic regression model, patients were subsequently matched 1:1 according to preoperative and operative variables to truly isolate the effect of obesity on surgical outcomes. Outcomes were compared between the matched cohorts using McNemar's test and the Wilcoxon signed rank test. Results: In unmatched multivariable analysis, rates of overall complications (7.2% vs. 5.3%, P = 0.0024), wound complications (5.5% vs. 3.6%, P = 0.0004), superficial surgical site infection (4.1% vs. 2.8%, P = 0.0050), and wound dehiscence (0.3% vs. 1.1%, P = 0.0005) were found to be statistically different between obese vs. non-obese, respectively. However, when comparing 1:1 matched obese and non-obese patients, only wound complications (4.6% vs. 3.1%, P = 0.0334) were significantly increased in the obese cohort. Conclusion: Using the most robust statistical tools available, obesity was

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The Influence of Obesity and Volume of Resection on Success in Reduction Mammaplasty: An Outcomes Study

Cited by 103 publications

References 3 publications

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

The Impact of Macromastia on Adolescents: A Cross-Sectional Study

Predicting breast reduction weight using the mass of breast ptosis

A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

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