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Breast Hypertrophy: A Real Pain in the Back
Lucie Lessard1, Constantine Papanastasiou1, Maryse Fortin2
1From the Division of Plastic and Reconstructive Surgery.
Plastic and Reconstructive Surgery
|February 2, 2023
Summary
Bilateral breast reduction (BBR) significantly reduces pain and improves physical function and quality of life. This plastic surgery procedure shows no evidence of permanent spinal skeletal changes, challenging current assessment scales.
Area of Science:
- Plastic Surgery
- Spine Imaging
- Pain Management
Background:
- Bilateral breast hypertrophy presents with varied symptoms, impacting patients' well-being.
- Bilateral breast reduction (BBR) is a common plastic surgery procedure.
- The effects of BBR on spinal balance, paraspinal muscle function, and physical performance require thorough evaluation.
Purpose of the Study:
- To evaluate the effects of BBR on spinal balance, paraspinal muscle function, and physical performance.
- To assess pain resolution following BBR using advanced imaging.
- To investigate potential anatomical skeletal sequelae after BBR.
Main Methods:
- Prospective, observational cohort study at McGill University Health Centre.
- Preoperative and postoperative data collection including patient questionnaires (BREAST-Q, Pain).
- Advanced spine imaging: magnetic resonance imaging (MRI) and EOS low-radiation spinal scan.
Main Results:
- Significant postoperative pain reduction observed.
- Up to 148% improvement in physical tests and all questionnaire categories.
- No statistically significant permanent anatomical skeletal sequelae detected; improved thoracic kyphosis.
Conclusions:
- BBR uniformly improves quality-of-life scores.
- Key findings include significant pain reduction and no spinal skeletal changes.
- Results may necessitate revised guidelines for insurance/payer assessments, potentially moving beyond the Schnur scale.
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