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Background
The association between obesity and macromastia is well established with recent studies demonstrating that only a third of patients with macromastia fall within the normal body mass index (BMI) range. As a result, increased obesity rates within our society will undoubtedly be accompanied by an increased incidence of macromastia. The ability to facilitate exercise and weight loss is often cited as a benefit of reduction mammaplasty. The purpose of this study was to measure the natural history of BMI change in an otherwise healthy adolescent population following bilateral breast reduction.
Methods
Records of 116 patients between 12 and 21 years of age who underwent reduction mammaplasty over a 7 year period were identified and reviewed for pre and postoperative height and weight, amount of breast tissue resected, and comorbidities. A paired t-test was used to compare each patient’s preoperative BMI to their postoperative BMI measurement.
Results
The mean preoperative body mass index (BMI) of 27.9 ± 6.1 kg/m2 did not differ significantly from the mean postoperative BMI of 28.2 ± 6.6 kg/m2. Additionally, after stratifying by preoperative BMI category, there was no significant difference between preoperative and postoperative BMI within each category (healthy, overweight, and obese). Although approximately half (41.4%) of the patients decreased their BMI, far fewer (6%) decreased BMI by at least 10% or entered a lower BMI category. In the same cohort, 18 (15.5%) patients increased their BMI by at least 10% postoperatively. No clear demographic features were identified for those patients that lost at least 10% of BMI.
Conclusion
We found no significant difference between mean preoperative and postoperative BMI among patients who underwent reduction mammaplasty. Our results suggest that while reduction mammaplasty may help some patients lose weight, meaningful weight loss postoperatively is rare. We recommend that treatment for overweight and obese macromastia patients include a weight loss program and nutritional counseling to facilitate long-term weight control.