ARTICLE

Breast Reduction Surgery- Proof of Benefit to Women

Does Breast Reduction Surgery improve quality of life?

The answer seems obvious however the latest addition of the Medical Journal of Australia has an article that proves that breast reduction surgery for women with symptomatic breast hypertrophy is cost effective for improving health related quality of life.

It is well known that woman suffering from large breasts (macromastia) often suffer from both physical and psychological problems. Common symptoms are chronic neck and shoulder pain, headaches, skin irritation, inability to participate in vigorous physical activities, reduced self-confidence and potentially social isolation and depression.

Many women seek to manage their problem by physiotherapy, chiropractic and weight loss. While these forms of management relieve symptoms only marginally it is known that breast reduction surgery can markedly improve these problems.

The study, conducted at The Flinders Medical Centre in Adelaide, compared women with macromastia who had undergone breast reduction surgery to women who had not. The women completed a questionnaire called the “SF-36 Health Related Quality of Life Instrument”. Prior to breast reduction surgery the scores relating to both physical and mental functioning for women with large breasts were significantly lower than women in the general population but improved to normal levels by 3 months after surgery.

This is a remarkable result and shows the effectiveness of breast reduction surgery in relieving the many symptoms associated with macromastia. The improvement was maintained at 6 and 12 months, as expected.

Interestingly, the average score for “satisfaction with breasts” was strikingly low before surgery but higher than for the general population after surgery. Scores for psychosocial, physical and sexual wellbeing were also markedly lower before surgery but similar to the general population after surgery.

Interestingly improvement occurred in all patients regardless of body mass index, age or complications.

Although breast reduction is available to patients in the private health care system in Australia, due to its classification as “cosmetic surgery”, access in the public system is severely restricted. This study shows that breast reduction compares very favourably with other widely accepted interventions such as hip or knee replacement, cataract surgery and bariatric surgery. It therefore should be widely available with access in the public health system.

Women with symptomatic macromastia are not looking for cosmetic improvement but are seeking relief from a condition that can seriously impair their quality of life. Women should not feel guilty about their desire for breast reduction surgery but should embark on the procedure with the knowledge that it is likely to dramatically improve their physical and psychological wellbeing.

An observation that I would add is that the cost benefit of breast reduction surgery can be dramatically improved by performing the operation as a Day Case or as short stay surgery. This is commonly practiced in the USA but surgeons in Australia have been slow to adapt their practises to day surgery.

At Avenue Aesthetic Surgery we were the first to offer breast reduction as Day Surgery in 1991. We have since performed many thousands of procedures as a Day Case and have found that patients recover quicker, complications are fewer and our results better. This is because Day Surgery breast reduction is actually a different system of surgery in which every aspect of the operation – from the anaesthetic to the way the operation is performed and especially the after-care, are all modified to minimise the risk of complications and ensure the best result with the quickest recovery.