Is there Enough Justification for Questioning Body Mass Index (BMI) as Exclusion Criteria of Reduction Mammoplasty in the Surgical Treatment of Symptomatic Macromastia?

Abstract

Background: Despite the fact that reduction mammaplasty is an effective and efficient treatment to symptomatic macromastia, frequently, women demanding this treatment are accepted or not depending on body mass index criteria. The aim of this work was to compare changes of quality of life on obese and no-obese women who undergoing breast reduction mammaplasty. Methods: A prospective study was performed on 56 consecutive women undergoing bilateral reduction mammaplasty for symptomatic macromastia, 21 of them had a BMI lower than 30 (No-obese group) and 35 with 30 or higher BMI (Obese group). Short Form SF-36 quality of life questionnaires were answered at interviews a week before the surgery and six months after. To evaluate the change of quality of life we used “effect size”. Results: Preoperative SF36 scores did not make differences between both groups. Six months after surgery only postoperative physical score of no-obese patients was significantly higher than obese one (52.11 vs 48.47, p>0.05). Both groups increased clearly their quality of life showing an increment of all SF36 domains with an effect size ranged from 0.53 to 2.07. More than seventy percent of obese women improved their scores exceeding means of preoperative scores. Conclusion: According to our results and the fact that the main goal of the breast reduction is ameliorate the quality of life there is no justification for exclusion obese patients with BMI >30 who suffer from symptomatic macromastia from reduction mammaplasty. Therapy: Level III of Evidence. Keywords: Reduction mammaplasty, Symptomatic macromastia, Obese, SF-36 health questionnaire, Effect size.