Reduction mammoplasty: comparison of results of plastic and general surgeons

To compare the results in patients who had reduction mammoplasty in a department of plastic surgery with those of patients who had the same operation in a department of general surgery.

Retrospective study of casenotes, and questionnaire.

Department of Plastic Surgery, University Hospital, Linköping, and Department of General Surgery, County Hospital, Motala.

All 250 patients who had undergone reduction mammoplasty during the five year period 1980-84 (Linköping, n = 173; Motala, n = 77).

Correlation between symptoms and expectations, and the patients' subjective assessment of the results.

There was no difference between the rates of response to the questionnaire (149/173, 86%, from those operated on in the department of plastic surgery compared with 68/77, 88%, in the department of general surgery). Median stay in hospital was 6 days in both groups, and the number of days of sick leave was 29 and 33 days, respectively. The most common histological diagnosis was hyperplastic breast tissue with or without fibroadenosis (149/173, 86%, compared with 64/77, 83%) and there was one carcinoma, which was detected before operation. The main reason for the operation in both groups was the weight of the breasts, which caused shoulder or back pain; in nearly half this interfered with activities of daily living. Most patients had high expectations of the operation, and in over 80% these were fulfilled.

We could find no reason why reduction mammoplasty should not be done by general surgeons, particularly in view of the long waiting lists, but there are some groups (for example, young women and patients either with exceptionally large breasts or who require only small reductions) who should still be treated by specialist plastic surgeons.