Reductions to improve physical & mental wellbeing

Breast reduction surgery produces measurable improvements in several important areas of health and quality of life, reports a study in the August issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The study used the BREAST-Q questionnaire, a well-validated survey instrument, to document the physical and psychosocial health benefits of breast reduction surgery. "The improvement in physical well-being is important for justification of insurance coverage," according to the paper by Dr. Michelle Coriddi and colleagues of Wexner Medical Center at the Ohio State University, Columbus.

Documented Gains in Well-Being after Breast Reduction

The study was designed to evaluate and confirm the benefits of breast reduction surgery—one of the most commonly performed breast plastic surgery procedures. Previous studies have found it highly effective in relieving symptoms related to overly large breasts.

The BREAST-Q was used to obtain a more complete picture of the clinical outcomes and is "the only questionnaire to assess breast reduction outcomes that meets international and federal standards for questionnaire development," according to Dr. Coriddi and coauthors.

In a series of 49 patients undergoing breast reduction, 78 percent anonymously completed the BREAST-Q before and/or after surgery. Changes in patient-reported satisfaction and quality of life after breast reduction were assessed.

The results showed significant improvement in all four areas evaluated on both the before and after questionnaires: satisfaction with the appearance of the breasts and psychosocial, sexual and physical well-being. On a 100-point scale, satisfaction with breast appearance increased from about 20 before surgery to more than 80 afterward.

There were also large improvements in scores for psychosocial well-being: from 41 to 84, sexual well-being: from 40 to 78, and physical well-being: from 43 to 81. As reported in previous studies, the procedure relieved pain in the breast, neck, back and shoulders.

BREAST-Q Helps Meet Need for Evidence-Based Outcomes Data

Satisfaction with breast appearance was most strongly related to satisfaction with the overall outcome. In addition to reducing pain, breast reduction led to significant improvements in sleep and ability to exercise.
The new study is important confirmation that breast reduction leads to improvements in physical and psychosocial well-being. "The improvement in physical activity, decrease in costly chronic medical complaints and improvement in overall quality of life indicated by this survey study validates insurance coverage for this procedure," the researchers write.

Dr. Coriddi and colleagues note that the benefits of breast reduction are seen shortly after surgery, as little as six weeks. Improvements also occur after relatively small reductions in breast size—which argues against arbitrary insurance coverage guidelines for the amount of tissue removed. The researchers plan further studies using the BREAST-Q to assess breast reduction outcomes, including more patients and long-term follow-up.

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