Timing Reduction Mammaplasty In The Adolescent Patient
Laura C. Nuzzi, BA1, Tannishtha Pramanick, BA1, Landis R. Walsh, BA1, 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 obese patients who were at least 9 years post menarche. Although postoperative breast regrowth occurred in 6% of our sample, there were no instances of glandular breast regrowth in obese patients who underwent surgery after this biological time point.
CONCLUSION: Our findings suggest that the risk for postoperative regrowth may be minimized if reduction mammaplasty is performed at least 9 years post menarche in obese patients. Many third-party insurers use strict age criteria (such as 18 years old) to authorize reduction mammaplasty, however, this age cut-off appears arbitrary in light of our findings.
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