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Breast reduction surgery—an easy formula to estimate the resection weight to be removed

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The preoperative prediction of therapeutic breast reduction weights which achieve both relief of symptoms and excellent shape and size breasts remains a challenge and, in addition, in the selection of patients with symptomatic macromatia for being treated by reduction mammaplasty the estimation of the amount of tissue to be removed plays an important role because this criterion is required almost universally. The objective of this study is to calculate a formula for the preoperative prediction of the amount of breast tissue which has to be removed in the treatment of symptomatic macromastia based on data obtained from a series of patients with symptomatic breast hypertrophy treated with reduction mammaplasty characterized by the fact that successful outcome (functional and cosmetic) had previously been achieved and assessed objectively.

Methods

A prospective study was performed on 39 patients undergoing reduction mammaplasty for breast hypertrophy. The Short Form (SF)-36 quality of life questionnaire (Spanish version 1.4, June 1999) and the Breast Reduction Assessed Severity Scale Questionnaire, which was double-blind translated, were both answered preoperatively, a week before, and postoperatively, 6 months after surgery, for testing the effectiveness of the treatment. The patients were asked to score cosmetic results (1 to 10, very bad to excellent) and how satisfied with the new breast size they were. Data were collected from these patients to calculate a formula for preoperative prediction of breast resection weight. Regression analysis was performed separately on each of 78 breasts of these patients with breast weight as dependent variable and sternal notch-to-nipple distance (SNN), inframammary fold-to-nipple distance (IMFN), age, body mass index (BMI) and ascent of the nipple areola complex (ANAC) as independent variables.

Results

A simple model combining two variables (IMFN, ANAC) is strongly correlated with actual resection weight with adjusted r 2 coefficient of 0.701. The formula breast weight (g) = (60(ANAC) (cm) + 50(IMFN) (cm)) − 648 can predict resection weight which obtains satisfactory cosmetic results and a relief of symptoms improving quality of life.

Conclusions

A new easy formula to estimate preoperatively the amount of breast tissue to be removed is offered to surgeons who are planning a breast reduction mammaplasty.

Level of evidence: level IV, risk/prognostic study

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References

  1. Singh KA, Losken A (2012) Additional benefits of reduction mammaplasty: a systematic review of the literature. Plast Reconstr Surg 129:562–570

    Article  CAS  PubMed  Google Scholar 

  2. Goldwyn R (1998) Breast reduction ad absurdum. Plast Reconstr Surg 102:246

    Article  CAS  PubMed  Google Scholar 

  3. Chadbourne EB, Zhang S, Gordon MJ, Ro EY, Ross SD, Schnur PL, Schneider-Redden PR (2001) Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies. Mayo Clin Proc 76:503–510

    Article  CAS  PubMed  Google Scholar 

  4. Gonzalez MA, Glickman LT, Aladegbami B, Simpson RL (2012) Quality of life after breast reduction surgery: a 10-year retrospective analysis using the breast Q questionnaire. Does breast size matter? Ann Plast Surg 69:361–363

    Article  CAS  PubMed  Google Scholar 

  5. Kalliainen LK, ASPS Health Policy Committee (2012) ASPS clinical practice guideline summary on reduction mammaplasty. Plast Reconstr Surg 130:785–789

    Article  CAS  PubMed  Google Scholar 

  6. Radosa JC, Radosa MP, Baum S, Mavrova R, Camara O (2013) Reduction mammaplasty for symptomatic macromastia: which factors influence the post-operative outcome? Arch Gynecol Obstet 287:715–722

    Article  PubMed  Google Scholar 

  7. Nguyen JT, Wheatley MJ, Schnur PL et al (2008) Reduction mammaplasty: a review of managed care medical policy coverage criteria. Plast Reconstr Surg 121:1092–1100

    Article  CAS  PubMed  Google Scholar 

  8. Sommer NZ, Zook EG, Verhulst SJ (2002) The prediction of breast reduction weight. Plast Reconstr Surg 109:506–511

    Article  PubMed  Google Scholar 

  9. Descamps MJ, Landau AG, Lazarus D, Hudson DA (2008) A formula determining resection weights for reduction mammaplasty. Plast Reconstr Surg 121:397–400

    Article  CAS  PubMed  Google Scholar 

  10. Appel JZ III, Wendel JJ, Zellner EG, Hagan KF, Shack RB, Corlew DS (2010) Association between preoperative measurements and resection weight in patients undergoing reduction mammaplasty. Ann Plast Surg 64:512–515

    CAS  PubMed  Google Scholar 

  11. Kocak E, Carruthers KH, McMahan JD (2011) A reliable method for the preoperative estimation of tissue to be removed during reduction mammaplasty. Plast Reconstr Surg 127:1059–1064

    Article  CAS  PubMed  Google Scholar 

  12. Alonso J, Prieto L, Antó JM (1995) La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin 104:771–776

    CAS  Google Scholar 

  13. Sirurdson L, Kirkland SA, Mykhalovskiy E (2007) Validation of a questionnaire for measuring morbidity in breast hypertrophy. Plast Reconstr Surg 120:1108–1114

    Article  Google Scholar 

  14. Kazis LE, Anderson JJ, Meenan RF (1989) Effect size for interpreting change in health status. Med Care 27(suppl):S178–S189

    Article  CAS  PubMed  Google Scholar 

  15. Cohen J (1977) Statistical power analysis for the behavioural sciences. Academic, New York

    Google Scholar 

  16. Tykkä E, Räsänen P, Tukiainen E (2010) Cost-utility of breast reduction surgery—a prospective study. J Plast Reconstr Aesthet Surg 63:87–92

    Article  PubMed  Google Scholar 

  17. Thoma A, Sprague S, Veltri K, Duku E, Furlong W (2007) A prospective study of patients undergoing breast reduction surgery: health-related quality of life and clinical outcomes. Plast Reconstr Surg 120:13–26

    Article  CAS  PubMed  Google Scholar 

  18. Saariniemi KM, Kuokkanen HO, Räsänen P, Sintonen H, Tukiainen EJ (2012) The cost utility of reduction mammaplasty at medium-term follow-up: a prospective study. J Plast Reconstr Aesthet Surg 65:17–21

    Article  PubMed  Google Scholar 

  19. Taylor AJ, Tate D, Brandberg Y, Blomqvist L (2004) Cost-effectiveness of reduction mammaplasty. Int J Technol Assess Health Care 220:269–273

    Google Scholar 

  20. 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. BMJ 313:454–745

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Saariniemi KMM, Keranen UH, Salminen-Peltola PK, Kuokkanen HOM (2008) Reduction mammaplasty is effective treatment according to two quality of life instruments. A prospective randomised clinical trial. J Plast Reconstr Aesthet Surg 61:1472–1478

    Article  PubMed  Google Scholar 

  22. Nicoletti G, Scevola S, Faga A (2009) Is breast reduction a functional or a cosmetic operation? Proposal of an objective discriminating criterion. J Plast Reconstr Aesthet Surg 62:1644–1646

    Article  PubMed  Google Scholar 

  23. Eder M, Grabhorn A, Waldenfels FV (2012) Prediction of breast resection weight in reduction mammaplasty based on 3-dimensional surface imaging. Surg Innov. doi:10.1177/1553350612460127

    Google Scholar 

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Acknowledgments

This study could not have been conducted without the generous collaboration of the patients who completed the questionnaires.

Ethical standards

This study has been approved by an ethics committee and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.

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Correspondence to Fernando Hernanz.

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Hernanz, F., Muñoz, P., Fidalgo, M. et al. Breast reduction surgery—an easy formula to estimate the resection weight to be removed. Eur J Plast Surg 37, 373–380 (2014). https://doi.org/10.1007/s00238-014-0958-0

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  • DOI: https://doi.org/10.1007/s00238-014-0958-0

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