Bilateral Reduction Mammaplasty Facilitates Subsequent Weight Loss in Obese Patients
Donald Groves, MD, Larissa Pamen, BS, MS, Kailash Kapadia, BS, Jocellie Marquez, MD, Michael Trostler, MD, Christopher Medrano, BA, Hayley Scott, BS, Tara Huston, MD, FACS.
Stony Brook University Hospital, Stony Brook, NY, USA.
Background: Macromastia is defined by enlarged breasts, due to glandular hypertrophy and excess fatty tissue. Patients exhibit low exercise tolerance leading to further breast enlargement. Half of patients demonstrate an elevated body mass index (BMI > 30) suggesting a correlation with obesity. A common benefit of reduction mammaplasty is the potential for weight loss. Our study aims to identify clinical factors associated with subsequent post-op changes in weight.
Methods: A retrospective chart review was performed of all patients who underwent bilateral reduction mammaplasty for symptomatic macromastia at a single academic institution (Stony Brook University Hospital) between January 1, 2000 and January 1, 2016. Patients had greater than 12 months follow-up to track resultant post-operative weight. Exclusion criteria consisted of: patients less than 18 years of age, history of prior breast surgeries, incidental cancer diagnosis in breast reduction tissue specimen, or history of weight loss surgery. Statistical analyses were performed to identify potential confounding factors.
Results: Two-hundred and sixty-nine patients met our inclusion criteria and were analyzed. Patients were stratified into two groups based on pre-operative BMI. Group 1 consisted of 117 patients (43%) with a BMI < 30 (i.e. non-obese); Group 2 consisted of 152 patients (57%) with a BMI > 30 (i.e. obese). The mean total weight of breast tissue resected for each group was 946 g and 1,695 g for Groups 1 and 2, respectively. For both groups, the mean patient age was 38 years and mean follow-up period was approximately 5 years (standard deviation 3.5 years). Patients in Group 1 (the non-obese group), had a mean pre-operative BMI 26.28 and post-operative BMI 26.84. Post-operatively, these patients demonstrated an overall mean BMI increase of 0.92 (with a mean annual post-operative BMI increase of 0.20). Patients in Group 2 (the obese group) had a mean pre-operative BMI 35.13 and post-operative BMI 34.19. Post-operatively, they demonstrated an overall mean BMI decrease of 0.30 (with a mean annual post-operative BMI decrease of 0.19). The difference between pre- and post-operative BMIs between the two groups was determined to be significant (p=0.0421).
Conclusion: Our results demonstrate that obese patients (BMI > 30) experience weight loss after undergoing bilateral reduction mammaplasty for macromastia, with a mean BMI reduction of 0.30. As the desire for postoperative weight loss and increased physical activity are common reasons to undergo reduction mammaplasty, this study adds valuable data to the discussion.
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