August 29, 2019 – Breast reduction surgery is a safe and effective procedure for adolescents and young women with pain and other concerns related to excessively large breasts, concludes a study in the September issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Although complications are common, they are mostly minor and do not reduce the benefits of breast reduction surgery in younger patients, according to the report by ASPS Member Surgeon Brian I. Labow and colleagues of Boston Children's Hospital. "Reduction mammaplasty significantly improves the breast-related symptoms and physical and psychosocial well-being of adolescent and young adult patients," the researchers write.
Even with Complications, Good Outcomes of Breast Reduction in Young Patients
Breast reduction is one of the most common plastic surgical procedures performed in the United States. One reason for its popularity is the enormous impact that large, heavy breasts have on women's quality of life, and the considerable physical and mental health improvements that surgery provides.
In previous studies, Dr. Labow and his team have shown that young patients with large breasts suffer severely decreased quality of life compared to their unaffected peers, and that these negative effects can be restored with surgery. According to the authors, "Adolescent reduction mammaplasty remains controversial due to concerns of and lack of data regarding postoperative breast growth, complications, and the effect on well-being."
The researchers analyzed complications and their impact on quality of life in 512 adolescent girls and young women, aged 12 to 21, who underwent breast reduction surgery between 2008 and 2017. Outcomes showed that the benefits of breast reduction surgery were similar to those reported in previous studies: pain and other breast-related symptoms decreased, while physical well-being, psychosocial functioning, and self-esteem improved.
About one-third of patients developed some kind of complication – however, the "vast majority" of complications were minor. "Patients had significant postoperative improvements in their physical and psychosocial well-being regardless if they experienced a complication," Dr. Labow and coauthors write.
The most common complication was thickened or raised scars (hypertrophic scarring), occurring in 20 percent of patients. Those concerned about scarring were offered treatment, either surgery or steroid injection.
One concern about reduction mammaplasty in adolescents is the risk of breast growth after surgery. This occurred in about five percent of patients in the study, leading to the return of breast-related symptoms in about half of cases. Noting that postoperative breast growth was unrelated to age, the researchers highlight the need to individually assess maturation in each patient.
While the benefits and risks of breast reduction surgery in adults are well-documented, few studies have focused on the risks and benefits of this procedure in adolescents and young women. Despite the fact that 80 percent of affected women first experience symptoms during adolescence, most women who undergo breast reduction surgery are around 50 years old.
The new study supports the good outcomes of breast reduction surgery in patients aged 12 to 21, despite a substantial risk of mostly minor complications. Dr. Labow and colleagues conclude: "Fear of potential complications should not preclude otherwise healthy patients from the benefits that reduction mammaplasty can provide adolescents."
"This study confirms that preoperative counseling about potential complications is a must," according to a video commentary by Plastic and Reconstructive Surgery Editor-in-Chief Rod J. Rohrich, MD. "While more research is always welcome, the results show that adolescent breast reduction is safe and effective."
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About Plastic and Reconstructive Surgery
For more than 70 years, Plastic and Reconstructive Surgery® (http://www.prsjournal.com/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
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