When to Perform Reduction Mammaplasty in the Adolescent Patient
Laura C. Nuzzi, BA; Tannishtha Pramanick, BA; Joseph M. Firriolo, MD; Catherine McNamara, BS; John G. Meara, MD, DMD, MBA; Brian I. Labow, MD Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Background:
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.
Conclusion:
Our findings suggest that the risk for postoperative regrowth may be 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. 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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