Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia

Rajiv Sood, Delora L. Mount, John J. Coleman, Jaime Ranieri, Sharon Sauter, Praveen Mathur, Bradley Thurston

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

A number of studies have documented subjective improvement in somatic and psychological symptoms following breast reduction surgery. Objective data demonstrating improved postoperative function have been more difficult to assess, and particularly with respect to pulmonary function, the results have been contradictory. In this prospective study, patients completed a comprehensive preoperative questionnaire modified from the American Thoracic Society Division of Lung Diseases Epidemiology Standardization Project (1978). This questionnaire noted subjective pulmonary symptoms and pulmonary medical history. In addition, subjective symptoms related to breast size, including back and neck pain and shoulder pain and grooving, and a subjective evaluation of body image, were evaluated. All subjects received preoperative pulmonary function testing, including spirometry, lung volume measurements, and measurement of peak inspiratory and expiratory flow rates and pressures. Eight weeks after breast reduction, a repeat questionnaire and pulmonary function testing were administered. Preoperative and postoperative pulmonary function values were compared using Cochran-Mantel-Haenszel tests, and correlations were tested between changes in pulmonary function test values and subjective symptom improvement. Forty-four patients underwent an average of 2228-g bilateral reduction. All of these patients had their surgical procedures preauthorized as medically necessary by their insurance carriers. All subjective parameters examined were statistically significantly improved following breast reduction (p < 0.001). Of the 17 patients with preoperative complaints of shortness of breath, all noted significant improvement following breast reduction surgery (p < 0.001). Of the objective pulmonary criteria evaluated, inspiratory capacity, peak expiratory flow rate, and maximal voluntary ventilation showed a statistically significant improvement following surgery (p < 0.05). These changes correlated with body mass index; the greater the index, the greater the change in maximal voluntary ventilation and peak expiratory flow rate. Smokers in this group had the largest change in maximal voluntary ventilation (10 < 0.008). No correlation could be found between preoperative pulmonary symptoms, a single subjective symptom, or grams of breast weight reduction and changes in pulmonary function tests. The results show that pulmonary parameters, related primarily to work of breathing (inspiratory capacity, maximal voluntary ventilation, peak expiratory flow rate), were statistically improved following breast reduction surgery, and these changes correlated with body mass index.

Original languageEnglish
Pages (from-to)688-694
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume111
Issue number2
DOIs
StatePublished - Feb 2003

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Mammaplasty
Maximal Voluntary Ventilation
Breast
Lung
Peak Expiratory Flow Rate
Inspiratory Capacity
Respiratory Function Tests
Body Mass Index
Work of Breathing
Lung Volume Measurements
Gigantomastia
Insurance Carriers
Shoulder Pain
Neck Pain
Body Image
Spirometry
Back Pain
Dyspnea
Lung Diseases
Weight Loss

ASJC Scopus subject areas

  • Surgery

Cite this

Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia. / Sood, Rajiv; Mount, Delora L.; Coleman, John J.; Ranieri, Jaime; Sauter, Sharon; Mathur, Praveen; Thurston, Bradley.

In: Plastic and Reconstructive Surgery, Vol. 111, No. 2, 02.2003, p. 688-694.

Research output: Contribution to journalArticle

Sood, Rajiv ; Mount, Delora L. ; Coleman, John J. ; Ranieri, Jaime ; Sauter, Sharon ; Mathur, Praveen ; Thurston, Bradley. / Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia. In: Plastic and Reconstructive Surgery. 2003 ; Vol. 111, No. 2. pp. 688-694.
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