Timing Reduction Mammaplasty in the Adolescent Patient
Laura C. Nuzzi, BA1, Tannishtha Pramanick1, Joseph M. Firriolo, MD2, Catherine T. McNamara, BS1, Brian I. Labow, MD1.
1Boston Children's Hospital, Harvard Medical School, Boston, MA, USA, 2University of California Davis Medical Center, Sacramento, CA, USA.
PURPOSE: Reduction mammaplasty effectively reduces breast-related symptoms and restores quality of life in young women. However, operating on adolescents remains controversial due, in part, to fear of potential postoperative breast regrowth.
METHODS: Symptomology, demographics, perioperative information, and postoperative outcomes were prospectively collected from patients undergoing bilateral reduction mammaplasty. Severity of macromastia was assessed using total breast tissue resection mass.
RESULTS: A total of 564 subjects were included in analyses, with a mean age at surgery of 17.9 years. Although years since menarche was positively associated with macromastia severity, this association was no longer significant when examining healthy-weighted patients who were at least 2 years post menarche, and overweight/obese patients who were at least 7 years post menarche. Although postoperative breast regrowth occurred in 5% of our sample, there were significantly fewer instances of glandular breast regrowth in patients who underwent surgery after these biological time points.
CONCLUSIONS: Our findings suggest that maximum efficacy may be reached, and the risk for postoperative regrowth minimized, if reduction mammaplasty is performed at least 2 years post menarche in healthy-weighted patients and at least 7 years post menarche in overweight/obese patients. Of note, many third-party insurers still use strict age criteria (such as 18 years old) to authorize reduction mammaplasty. In light of our work, this age cut-off appears arbitrary.
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