Does breast size matter? Overview of Reduction mammoplasty

Reduction mammoplasty is not always a cosmetic procedure and may be a medically necessary procedure in some. Large breasts can have a detrimental effect on a woman's life and reduction surgery can improve quality of life. Most studies show a marked improvement in quality of life in women who undergo breast reduction for clinical indications.

·       Quality of life after breast reduction surgery: a 10-year retrospective analysis using the Breast Q

questionnaire

Marco A Gonzalez I, Laurence T Glickmon, Bola Aladegbomi, Roger L Simpson
 

Results: The study supports a positive outcome after breast reduction surgery. Over 95% of the patients surveyed were satisfied and would do it again. It demonstrates the improvement of the patient's quality of life regardless of the amount of breast tissue removed. Furthermore, it suggests that the size and weight of the patient has no impact on this outcome. As we face new government and insurance restrictions for surgeries that have both cosmetic and reconstructive value, patient reported outcome studies may have an influence on future third-party payer.

·       Improvement in quality of life and self-esteem after breast reduction surgery​​​​​​

Arnaldo A Mello 1, Neide A M Domingos, M Cristina Miyazaki
 

Results: Both self-esteem and quality of life significantly improved after breast reduction surgery.

 

Medically necessary Breast Reductions:

Not all reduction mammoplasties are done for cosmetic reasons alone. Many women with large breasts experience varying degrees of physical and psychological distress, often including:

• Pain in the breasts, neck, back or shoulders;
• Bad posture;
• Inability to participate in sports;
• Low self-esteem; and
• Increased self-consciousness.

Reduction mammoplasty with nipple repositioning aims to reduce the size of the breasts to be proportional to the woman's physique and relieve symptoms of macromastia. More importantly, a great improvement in self-esteem and mental health is observed. It also acts as a stimulus for postoperative weight loss by improved ability to exercise and motivation to lose weight to improve body image.

 

Breast reduction mammoplasty to resect breast cancers

Oncoplastic breast surgery is based upon integration of plastic surgical techniques for immediate breast reshaping after wide excision for breast cancer.

Depending on the location of cancer, various reduction techniques can be utilised to achieve a good oncological outcome along with correction of symptoms of macromastia in women with moderate to large breasts and obtain pleasing aesthetic outcomes. A symmetrising reduction can be done for the contralateral side of cancer at the same time or at a later date.

 

Medicare and Reduction surgery of breasts

Your patient may be eligible for Medicare rebate if they meet the criteria of the item numbers on MBS schedule. It is important to demonstrate clinical need and hence a GP referral noting the symptoms such as neck and shoulder pain needing medication with all other causes ruled out, outlining the psychosocial impact to the patient etc. will help determine eligibility.

 

Medicare descriptors are

Item 45520: Reduction mammaplasty (unilateral) with surgical repositioning of nipple, in the

context of breast cancer or developmental abnormality of the breast

Item 45523: Reduction mammaplasty (bilateral) with surgical repositioning of the nipple: (a) for

patients with macromastia and experiencing pain in the neck or shoulder region; and (b) not with

insertion of any prosthesis.