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Breast Reduction Surgery: When Is It Necessary for a Young Woman?

Macromastia, or breast hypertrophy, is characterized by breasts that are disproportionately large compared to the rest of the body. Young women with macromastia often have problems with upper back and neck strain/pain, shoulder grooving from bra straps, trouble participating in sports or activities because breast tissue gets in the way and, sometimes, skin rashes between and beneath the breasts.

How is it treated?

Treatment for macromastia includes weight management, physical therapy and in some cases surgical reduction of the breasts. Breast reduction (mammoplasty) is a procedure that reduces the size of the breasts by removing excess breast tissue, fat and skin. The areola (the pigmented skin around the nipple) may be reduced in size and repositioned as well. The surgery helps to achieve a breast size that is in proportion with a patient’s body and helps to alleviate the discomfort associated with overly large breasts.

What should a female consider before considering a breast reduction?

For patients who are excessively overweight or obese, a weight loss program should be completed prior to considering surgical intervention. Breast size can be affected by weight fluctuations, so it is important to be at a stable, healthy weight for at least six months to one year prior to considering surgery.

In addition, if a female is experiencing significant back or neck pain, it may be beneficial to first institute treatment with over the counter medications or physical therapy in order to improve posture and help relieve symptoms of neck and back strain.

If the pain is significant, it may be necessary to visit a pain team or a pain clinic. These specialized practitioners can focus on treating pain with special medications and other non-pharmacologic treatment methods to assist with chronic pain.

If a young woman is experiencing emotional stress or has psychiatric concerns, she may need to be treated by a behavioral health team consisting of a psychologist or psychiatrist. Breast reduction surgery is a big commitment and females should be emotionally and mentally ready to be able to understand the long-term effects that one can experience with this type of surgery. These effects can vary from psychological to physical symptoms; from coping with pain and accepting the change in body image, to scarring and the chance that there will be an inability to breastfeed in the future.

What can be expected at an initial consultation for surgery?

At the visit(s), a young woman can expect:

  • A medical history including information about any previous surgical procedures, past and present medical conditions, family history of breast cancer, all medications or herbal supplements the patient is taking and any history of tobacco and drug use.
  • A physical examination to determine of the size and shape of the breasts, the quality of skin and placement of the nipples and the extent of breast enlargement.
  • Measurements and photographs for the medical record if the patient is deemed to be a surgical candidate.
  • Discussion of possible risks and complications of the surgical procedure.

When is the best time to have surgery?

Surgery should be put off until a young woman is close to her adult height and the breasts are mature. Typically, this is two to three years after the onset of her first period, but it can vary from patient to patient.

This is a surgery that will potentially impact a young woman’s future, so it is also important to make sure that she is emotionally ready to commit to a breast reduction.

To learn more about the Plastic and Reconstructive Surgery Clinics at Nationwide Children’s Hospital, or to request an appointment, click here.

Andrea Brun, CPNP-PC
Andrea Orban, is a pediatric nurse practitioner in the department of Plastic and Reconstructive Surgery. She holds a BSN from The Ohio State University and a MSN from the University of Cincinnati, and has previous experience in primary care and neurosurgery. Ms Orban sees patients in the Cleft Lip & Plate Center and Center for Craniofacial Disorders, the Hemangioma and Vascular Malformations clinic, General Plastic Surgery, as well as the Hand, Microsurgery, and Brachial Plexus Program.

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