Aesthetic Plastic Surgery

, Volume 36, Issue 6, pp 1311–1319 | Cite as

A Study of Postural Changes After Breast Reduction

  • Marco MazzocchiEmail author
  • Luca Andrea Dessy
  • Silvia Di Ronza
  • Pierpaolo Iodice
  • Raoul Saggini
  • Nicolò Scuderi
Original Article Breast



Numerous factors such as the equilibrium of body masses and psychological status influence human posture. Breast reduction, on the one hand, produces a sudden change in this equilibrium, and on the other hand, it can modify the psychological status, significantly improving body image and self-esteem. This study aimed to assess postural changes after breast reduction by studying the position and orientation in space of the body and center of pressure.


The study enrolled 52 patients with breast hypertrophy scheduled to undergo breast reduction. Posture was evaluated before surgery and during the first year after surgery by quantifying the centers of mass using the Fastrak system and the center of pressure using stabilometry. The Wilcoxon signed-rank sum test was used to detect any changes.


Retropositioning of the upper part of the body, confirmed by baropodometric analysis, was observed in the early postoperative period. The biomechanical system subsequently stabilized, reaching equilibrium 1 year after surgery.


The authors believe that postural changes after breast reduction are due to changes in body mass as well as to the effects of physical and psychological factors on posture. Indeed, breast hypertrophy often is associated with kyphosis as patients try to hide what they consider to be a source of embarrassment. A new breast eliminates previous dissatisfaction with body image, reduces anxiety, and increases self-esteem. Improvements in body image and reduced weight in the anterior part of the body help to correct this postural disorder.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Breast reduction Human posture Fastrak system Stabilometry Centre of mass Centre of pressure 


  1. 1.
    Goin MK, Goin JM, Gianini MH (1977) The psychic consequences of a reduction mammaplasty. Plast Reconstr Surg 59:530–534PubMedGoogle Scholar
  2. 2.
    Shewmake KB (1994) Reduction mammaplasty and mastopexy. In: Barton EF, Darling G, Peterson S (eds) Selected readings in plastic surgery. vol 7. Baylor University Medical Center, Dallas, TX, pp 1–27Google Scholar
  3. 3.
    Blomqvist L, Eriksson A, Brandberg Y (2000) Reduction mammaplasty provides long-term improvement in health status and quality of life. Plast Reconstr Surg 106:991–997PubMedCrossRefGoogle Scholar
  4. 4.
    Glatt BS, Sarwer DB, O’Hara DE, Hamori C, Bucky LP, LaRossa D (1999) A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg 103:76–82PubMedCrossRefGoogle Scholar
  5. 5.
    Davis GM, Ringler SL, Short K, Sherrick D, Bengtson BP (1995) Reduction mammaplasty: long-term efficacy, morbidity, and patient satisfaction. Plast Reconstr Surg 96:1106–1110PubMedCrossRefGoogle Scholar
  6. 6.
    Atterhem H, Holmner S, Janson PE (1998) Reduction mammaplasty: symptoms, complication, and late results. A retrospective study on 242 patients. Scand J Plast Reconstr Surg Hand Surg 32:281–286PubMedCrossRefGoogle Scholar
  7. 7.
    Berg A, Stark B, Malec E (1994) Reduction mammaplasty: a way of helping females with neck, shoulder, and back pain symptoms. Eur J Plast Surg 17:84–86Google Scholar
  8. 8.
    Boschert MT, Barone CM, Puckett CL (1996) Outcome analysis of reduction mammaplasty. Plast Reconstr Surg 98:451–454PubMedCrossRefGoogle Scholar
  9. 9.
    Gonzalez F, Walton RL, Shafer B, Matory WE Jr, Borah Gl (1993) Reduction mammaplasty improves symptoms of macromastia. Plast Reconstr Surg 91:1270–1276PubMedCrossRefGoogle Scholar
  10. 10.
    Klassen A, Fitzpatrick R, Jenkinson C, Goodacre T (1996) Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey. Br Med J 313:454–457CrossRefGoogle Scholar
  11. 11.
    Miller AP, Zacher JB, Berggren RB, Falcone RE, Monk J (1995) Breast reduction for symptomatic macromastia: can objective predictors for operative success be identified? Plast Reconstr Surg 95:77–83PubMedCrossRefGoogle Scholar
  12. 12.
    Canales JZ, Cordás TA, Fiquer JT, Cavalcante AF, Moreno RA (2010) Posture and body image in individuals with major depressive disorder: a controlled study. Rev Bras Psiquiatr 32:375–380PubMedCrossRefGoogle Scholar
  13. 13.
    Raispis T, Zehring RD, Downey DL (1995) Long-term functional results after reduction mammaplasty. Ann Plast Surg 34:113–116PubMedCrossRefGoogle Scholar
  14. 14.
    Letterman G, Schurter M (1980) The effects of mammary hypertrophy on the skeletal system. Ann Plast Surg 5:425–431PubMedCrossRefGoogle Scholar
  15. 15.
    Sigurdson L, Mykhalovskiy E, Kirkland SA, Pallen A (2007) Symptoms and related severity experienced by women with breast hypertrophy. Plast Reconstr Surg 119:481–486PubMedCrossRefGoogle Scholar
  16. 16.
    Findikcioglu K, Findikcioglu F, Ozmen S, Guclu T (2007) The impact of breast size on the vertebral column: A radiologic study. Aesthetic Plast Surg 31:23–27PubMedCrossRefGoogle Scholar
  17. 17.
    Shik ML, Orlovsky GN (1976) Neurophysiology of locomotor automatism. Physiol Rev 56:456–501Google Scholar
  18. 18.
    Grasso R, Peppe A, Stratta F, Angelini D, Zago M, Stanzione P, Lacquaniti F (1999) Basal ganglia and gait control: apomorphine administration and internal pallidum stimulation in Parkinson’s disease. Exp Brain Res 126:139–148PubMedCrossRefGoogle Scholar
  19. 19.
    Mori S (1987) Integration of posture and locomotion in acute decerebrate cats in awake, freely moving cats. Prog Neurobiol 28:161–195PubMedCrossRefGoogle Scholar
  20. 20.
    Mori S, Nishimura H, Kurakami C, Yamamura T, Aoki M (1978) Controlled locomotion in the mesencephalic cat: distribution of facilitatory and inhibitory regions within pontine tegmentum. J Neurophysiol 41:1580–1591PubMedGoogle Scholar
  21. 21.
    Mori S, Sakamoto T, Ohta Y, Takakusaki K, Matsuyama K (1989) Site-specific postural and locomotor changes evoked in awake, freely moving intact cats by stimulating the brainstem. Brain Res 505:66–74PubMedCrossRefGoogle Scholar
  22. 22.
    Jankowska E, Edgley S (1993) Interactions between pathways controlling posture and gait at the level of spinal interneurones in the cat. Prog Brain Res 97:161–171PubMedCrossRefGoogle Scholar
  23. 23.
    Maffey-Ward L, Jull G, Wellington L (1996) Toward a clinical test of lumbar spine kinesthesia. J Orthop Sports Phys Ther 24:354–358PubMedGoogle Scholar
  24. 24.
    Willems JM, Jull GA, Ng JKF (1996) An in vivo study of the primary and coupled rotations of the thoracic spine. Clin Biomech 11:311–316Google Scholar
  25. 25.
    Swinkels A, Dolan P (1998) Regional assessment of joint position sense in the spine. Spine 23:590–597PubMedCrossRefGoogle Scholar
  26. 26.
    Oliveira LF, Simpsom DM, Nadal J (1996) Calculation of area of stabilometric signals using principal components analysis. Physiol Meas 17:305–312PubMedCrossRefGoogle Scholar
  27. 27.
    Mello RGT, Oliveira LF, Nadal J (2007) Anticipation mechanism in body sway control and the influence of muscle fatigue. J Electromyogr Kinesiol 17:739–746PubMedCrossRefGoogle Scholar
  28. 28.
    Chao JD, Memmel HC, Redding JF, Egan L, Odom LC, Casas LA (2002) Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg 110:1644–1652PubMedCrossRefGoogle Scholar
  29. 29.
    Freire M, Neto MS, Garcia EB, Quaresma MR, Ferreira LM (2007) Functional capacity and postural pain outcomes after reduction mammaplasty. Plast Reconstr Surg 119:1149–1156PubMedCrossRefGoogle Scholar
  30. 30.
    Bouman FG (1970) Volumetric measurement of the human breast and breast tissue before and during mammaplasty. Br J Plast Surg 23:263–264PubMedCrossRefGoogle Scholar
  31. 31.
    French Association of Posturology (1985) Normes 85–Edité es par l’Association Francaise de PosturologieGoogle Scholar
  32. 32.
    Bizzo G, Guillet N, Patat A, Gagey PM (1985) Specifications for building a vertical force platform designed for clinical stabilometry. Med Biol Eng Comput 23:474–476PubMedCrossRefGoogle Scholar
  33. 33.
    Morrison DF (1978) Multivariate statistical methods, 2nd edn. McGraw-Hill, AucklandGoogle Scholar
  34. 34.
    Lassus C (1996) A 30-year experience with vertical mammaplasty. Plast Reconstr Surg 97:373–380PubMedCrossRefGoogle Scholar
  35. 35.
    Black FO, Shupert CL, Horak FB, Nashner LM (1983) Abnormal postural control associated with peripheral vestibular disorders. In: Pompeiano O, Allum JHJ (eds) Vestibulospinal control of posture and locomotion. Elsevier, Amsterdam, pp 263–275Google Scholar
  36. 36.
    Diener HC, Dichgans J, Guschlauber B, Man H (1984) The significance of proprioception on postural stabilization as assessed by ischemia. Brain Res 296:103–109PubMedCrossRefGoogle Scholar
  37. 37.
    Hood JD (1980) Unsteadiness of cerebellar origin: an investigation into the cause. J Laryngol Otol 94:865–876PubMedCrossRefGoogle Scholar
  38. 38.
    Karnath HO, Ferber S, Dichgans J (2000) The neural representation of postural control in humans. Proc Natl Acad Sci 97:13931–13936PubMedCrossRefGoogle Scholar
  39. 39.
    Rondot P, Odier F, Valade D (1992) Postural disturbances due to homonymous hemianopic visual ataxia. Brain 115:179–188PubMedCrossRefGoogle Scholar
  40. 40.
    Galeazzi GM, Monzani D, Gherpelli C, Covezzi R, Guaraldi GP (2006) Posturographic stabilisation of healthy subjects exposed to full-length mirror image is inversely related to body-image preoccupations. Neurosci Lett 410:71–75PubMedCrossRefGoogle Scholar
  41. 41.
    Woollacott MH, Shumway-Cook A, Nashner L (1986) Aging and postural control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev 23:97–114PubMedCrossRefGoogle Scholar
  42. 42.
    Lacour M, Barthelemy J, Borel L, Magnan J, Xerri C, Chays A, Ouaknine M (1997) Sensory strategies in human postural control before and after unilateral vestibular neurotomy. Exp Brain Res 115:300–310PubMedCrossRefGoogle Scholar
  43. 43.
    Peterka RJ (2002) Sensorimotor integration in human and postural control. J Neurophysiol 88:1097–1118PubMedGoogle Scholar
  44. 44.
    Schoner G (1991) Dynamic theory of action-perception patterns: the “moving room” paradigm. Biol Cybern 64:455–462PubMedCrossRefGoogle Scholar
  45. 45.
    van der Kooij H, Jacobs R, Koopman B, Grootenboer H (1999) A multisensory integration model of human stance control. Bio Cybern 80:299–308CrossRefGoogle Scholar
  46. 46.
    Brito CA Jr (1995) Alterações posturais. In: Lianza S (ed) Medicina de Reabilitação. Guanabara Koogan, Rio de Janeiro, pp 35–67Google Scholar
  47. 47.
    Kendall FP, McCreary EK (1996) Músculos: Provas e Funções, 3rd edn. São Paulo, ManoleGoogle Scholar
  48. 48.
    Wright EF, Domenech MA, Fischer JR Jr (2000) Usefulness of posture training for patients with temporomandibular disorders. J Am Dent Assoc 131:202–210PubMedGoogle Scholar
  49. 49.
    Smith LK, Weiss EL, Lehmkuhl LD (1997) Cinesiologia Clínica de Brunnstron, 5th edn. São Paulo, ManoleGoogle Scholar
  50. 50.
    Rasch PJ, Burke RK (1997) Cinesiologia e Anatomia Aplicada, 5th edn. Guanabara Koogan, Rio de JaneiroGoogle Scholar
  51. 51.
    Schilder P (1994) A Imagem Do Corpo: As Energias Construtivas da Psique, 2nd edn. São Paulo, Martins FontesGoogle Scholar
  52. 52.
    Slade PD (1994) What is body image? Behav Res Ther 32:497–502PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012

Authors and Affiliations

  • Marco Mazzocchi
    • 1
    Email author
  • Luca Andrea Dessy
    • 2
  • Silvia Di Ronza
    • 2
  • Pierpaolo Iodice
    • 3
  • Raoul Saggini
    • 3
  • Nicolò Scuderi
    • 2
  1. 1.Department of Plastic SurgeryUniversity of PerugiaRomaItaly
  2. 2.Department of Plastic SurgerySapienza University of RomeRomeItaly
  3. 3.Department of Neuroscience and Imaging“G. d’Annunzio” University of ChietiChietiItaly

Personalised recommendations