Women who suffer from painful physical symptoms of overly large breasts show greater improvement with breast reduction surgery over conservative treatments such as special bras, weight loss, physical therapy, or medication reports the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The study also confirms the benefits of breast reduction surgery are considerable and not dependent on body weight, bra cup size or amount of tissue removed.

"This study provides additional and even more convincing evidence that breast reduction effectively improves the overall health and wellness of large-breasted women with chronic pain related to their breast size," said E. Dale Collins, MD, a plastic surgeon at Dartmouth Hitchcock Medical Center in New Hampshire and first author of the study. "The findings also support the fact that more conservative methods of treatment -- often required by insurance companies -- have failed to deliver significant or lasting relief."

The study group included 363 women, 179 women with a median bra cup size of DD who underwent breast reduction surgery, and two sets of control groups that did not - 96 women with a bra cup size less than D and 88 women with a bra cup size of D or larger. Prior to surgery, 50 percent of the patients who had breast reduction surgery reported pain in the upper back, shoulders, neck, and lower back all or most of the time. While less than 10 percent experienced these conditions after surgery.

Prior to seeking surgical relief, the patients who had breast reduction surgery tried a number of conservative treatments including weight loss, supportive bras, medications and physical therapy. About 85 percent of these women previously tried weight loss to relieve their symptoms, but more than half found the effort completely ineffective and none of the women reported complete or permanent symptom relief. Additionally, 77 percent of them tried one or more medications to manage pain, including narcotic and non-narcotic analgesics, non-steroidal anti-inflammatory agents and muscle relaxants. After surgery, only 13 percent of these women required medication, just slightly more than the control group consisting of women with a bra cup size less than D (11 percent).

None of the conservative treatments provided full or permanent relief of symptoms. In contrast, both pain and overall health were markedly improved by breast reduction surgery, restoring patients to normal levels of function.
Plastic surgeons have long observed that reducing breast mass can effectively alleviate the symptoms associated with overly large breasts. However, insurance denials and policy exclusions for the procedure are becoming increasingly common. Insurers often request patients seeking surgery try conservative measures first. Additionally, some companies set arbitrary body weight restrictions. This study demonstrates that all women, regardless of weight, benefit from surgery and that conservative treatment weight loss was not effective in relieving related symptoms.

"I believe insurance companies drastically underestimate the severity of symptoms associated with having overly large breasts," said Dr. Collins. "Patients seeking surgery reported suffering from pain comparable to low back pain or arthritis. Breast reduction surgery is a safe and highly effective treatment option and should not be considered a last resort."

According to ASPS expanded statistics, 99,428 women had breast reduction surgery in 2001. Breast reduction surgery was the fifth most performed reconstructive plastic surgery procedure in 2001.

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