Reduction mammaplasty in adolescents: a review
of the indications, timing, and outcomes in a regional plastic
Kavita S. Sharma
T. M. Brotherston
Received: 16 July 2014 /Accepted: 10 September 2014 / Published online: 30 September 2014
Springer-Verlag Berlin Heidelberg 2014
Background With an increase in the incidence of childhood
obesity and body awareness among adolescents, there has been
a rise in the number of reduction mammaplasties being per-
formed in this group of patients. Our study aims to review the
indications, complications, and long-term outcomes of reduc-
tion mammaplasty in this subgroup of patients.
Methods A retrospective review included female patients un-
der 19 years old undergoing reduction mammaplasty. Data was
obtained on patient demographics, mechanical and psycholog-
ical symptoms and postoperative complications. A qualitative
prospective questionnaire study was performed between 5 to
13 years following surgery. Responses were rated using the
standardized Likert Scaling system to assess subjective benefits
of the procedure.
Results Thirty-six females had unilateral or bilateral reduction
mammaplasty at a mean age of 17.40 years. Primary mechan-
ical symptoms included back/neck pain, difficulty sleeping, and
intertrigo. The principal psychological complaints were in-
creased self-consciousness, low self-esteem, depression, and
bullying. Sixty-seven percent agreed there was an immediate
resolution of mechanical symptoms, and 47 % reported an
improvement in psychological symptoms following surgery.
Conclusions Reduction mammaplasty is especially beneficial
in this group of patients as they suffer increased psychological
comorbidities versus their adult counterparts. Patients need to
be adequately assessed and counseled for optimal outcome.
Level of Evidence: Level IV, therapeutic study.
Keywords Reduction mammaplasty
Reduction mammaplasty is regarded as the mainstay of treat-
ment in the management of macromastia . This is defined as
the massive enlargement of the female breast disproportionate
to the growth of the remainder of the body. It mainly occurs in
females who are either pubertal or pregnant. In the pubertal and
para-pubertal groups, the causes include endocrine changes,
childhood obesity, and juvenile (virginal) hypertrophy .
The breast often grows to an enormous position rapidly with
little chance of spontaneous remission .
The number of cases of reduction mammaplasty being per-
formed in adolescents is on the rise. In the past 10 years, there
has been a mean of 2 to 5,000 procedures done per year in
this group accounts for about 2.5 % of all reduction
mammaplasties on a yearly basis . This can be attributed to
the increasing prevalence of childhood obesity , adolescent
macromastia, and a lower threshold for surgical intervention.
The development of macromastia in adolescents can be
distressing in a very crucial part of a girl’s life. During puberty,
a teenager experiences rapid and major changes in appearance
and maybe displeased with elements of her new body. It is at
this age when body image, peer pressure, and a desire to fit into
the norms of society come into play. Adolescents can be psy-
chologically affected due to this condition. Social issues known
to occur include inability to attain proper fitting clothes, avoid-
ance of swimming, exercises, and physical activity, and teasing
and bullying from peers. This results in a loss of confidence and
low self-esteem that can ultimately lead to clinical depression
and social isolation.
This project was presented orally at the BAPRAS/ESPRAS International
Meeting, Edinburgh, 7th–11th July 2014.
K. S. Sharma (*)
P. L i m
T. M. Brotherston
Department of Plastic and Reconstructive Surgery, Sheffield
Children’s Hospital, Western Bank, Sheffield, South Yorkshire S10
Eur J Plast Surg (2014) 37:661–666