Breast Reduction Can Relieve Back Pain in Teens

A new study from the University of Rochester Medical Center (URMC) demonstrates that adolescents who experience significant back and neck pain from macromastia can receive the same—if not greater—health and psycho-social benefits from breast reduction surgery as grown women.

In addition to severe neck, back and shoulder pain, adolescents with very large breasts can develop skin infections, have trouble participating in sports, and develop deep grooves in their shoulders from the weight on their bra straps. In some cases, the problems can be so severe that it can be difficult to breathe and may cause spinal curvature. Additionally, teens can develop social problems due to the condition.

“These are not insignificant problems for these young women to endure,” said John Girotto, MD, associate professor of Plastic and Reconstructive Surgery, Neurosurgery and Pediatrics. “This publication shows that they benefit greatly from the surgery. Why should we make them wait 20 years to relieve their physical and emotional pain?”

The paper, published in the International Journal of Surgery, examined 76 adolescent patients who had breast reduction surgery at URMC. The average age of the patients was just older than 16, the average cup size was DDD, and all operations were covered by insurance. Of the subjects, 65% were obese but none were given the procedure before weight loss was first attempted through nutrition guidance and exercise.

“One of the interesting findings in this study was that cup size was not directly related to BMI,” said Peter Koltz, MD, a plastic surgery resident at URMC and first author of the paper. “This indicates that breasts are not necessarily in proportion to the patient’s body size and shape.” He also noted that it can be very difficult for this population to exercise before the surgery because they can be, essentially, disabled.

Macromastia is becoming more of an issue in adolescents because of the earlier onset of puberty and the rise in childhood obesity, according to Girotto, who pointed out that often the teens are not the first in their family to get the surgery. The URMC study is the first to examine the reasons for having the surgery and outcomes among adolescents.

“Mothers who have already had the surgery often bring their daughters in. They don’t want their girls to have to wait as long they had to,” Girotto said. “Even when mothers learn it’s very possible their child will have to have another “touch-up” or revisional breast surgery later in life, they want to do it.”

Koltz urged plastic surgeons to consider that the fact that the risks for adolescents are the same as they are for adults, despite risks generally being lower for most pediatric surgeries. Young women also may not be finished growing and developing, and may need a revision as they age. He said surgeons should make sure their patients understand that they may also have trouble breastfeeding, either being unable to produce any milk or unable to produce enough milk.

Finally, Koltz mentioned that just like all plastic surgery, careful patient selection is one of the most important components to a successful outcome.

As long as patients are well informed and understand all potential risks and benefits of the operation, satisfaction can be very high in breast reduction patients.

Source: University of Rochester Medical Center