Young breast reduction surgery patients report long-term benefits decades after the procedure

Women who underwent breast reduction surgery before age 25 continue to report lasting benefits 10 to 30 years following the procedure, according to a study in the November issue of Plastic and Reconstructive Surgery^®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Young reduction mammaplasty patients experience excellent breast-related quality of life decades after surgery."

Kate B. Krucoff, MD, and coauthors

The study finds that some long-term outcomes after breast reduction surgery – including sexual well-being and satisfaction with breasts – are even higher than in women who have never had breast surgery.

According to the 2018 American Society of Plastic Surgeons annual statistics report, there were 43,591 breast reduction procedures last year-;a number that's held steady since the Society began tracking the operation in 2011.

The study included women who were younger than 25 when they underwent breast reduction surgery between 1980 and 2003. The quality of life (QoL) outcomes were evaluated using a validated questionnaire, the BREAST‑Q©. Thirty-seven women completed the questionnaire. All women in the study were followed up for at least 10 years; median follow-up was 21 years, with a maximum of 32 years.

"Overall, participants demonstrated high satisfaction and well-being," Kate B. Krucoff, MD, and coauthors write. The study focused on four BREAST‑Q outcomes, all scored on a 0 (worst) to 100 (best) scale. For two outcomes, scores were significantly higher for women who underwent breast reduction at a young age, compared to a normative group of women who never had breast surgery. Average score for satisfaction with breasts was 67 for women who underwent breast reduction, compared to 57 in the normative group. Women who underwent breast reduction also gave higher ratings for sexual well-being: 72 versus 55.

Women who underwent breast reduction also had good scores for psychosocial well-being (76 out of 100) and physical well-being (81 out of 100). These scores were similar to the normative group.

Breast reduction has demonstrated benefits in reducing symptoms (such as back and neck pain) and improving psychological well-being (such as poor body image and low self-esteem) in women with overlarge breasts. "Although young patients experience many of the same symptoms as adults, controversy exists around performing reduction mammaplasty in a young patient population," Dr. Krucoff and colleagues write. The new report is one of the longest follow-up studies of young reduction mammaplasty patients, and the first to use the validated BREAST‑Q questionnaire.

The results show enduring benefits in a group of women who underwent breast reduction before age 25. Benefits persisted even though the women likely underwent hormonal changes affecting the breast, including pregnancy, breastfeeding, and menopause. "Thus, avoiding or delaying reduction mammaplasty in young patients may prevent them from achieving lasting improvements in satisfaction and well-being," the researchers add.

The study also has implications for insurance coverage and other obstacles to undergoing breast reduction surgery, especially in younger women. Dr. Krucoff and coauthors conclude, "Surgeons and third-party payers should be aware of these data and advocate for young patients to gain access to care."