title: Breast reduction surgery in the UK and Ireland - current trends.
abstract: BACKGROUND
  This paper reviews the current status of bilateral breast reduction surgery in the UK and Ireland. It examines the pre-operative, operative and postoperative management of women.
  
  
  METHODS
  A questionnaire established information about surgeons' experience, bilateral breast reduction work-load, pre-operative assessment, selection criteria, issues of operative technique and postoperative management. This was sent to 230 consultant plastic surgeons working in the NHS in the UK and Ireland.
  
  
  RESULTS
  There was a 61% response rate. Of respondent surgeons, 82% always perform pre-operative photography, 71% never do a mammogram even in patients above the age of 50 years. Body mass index (BMI) is the most commonly used criteria for patient selection (60%). Two-thirds of the surgeons use an inferior pedicle technique and 75% of surgeons work in health authorities that restrict breast reduction surgery.
  
  
  CONCLUSIONS
  There was significant variation in practice among surgeons performing bilateral breast reduction. This may reflect a lack of evidence base for practise. Published literature focuses almost exclusively on the description of different techniques. Further work is required to evaluate the role of pre-operative mammography, specimen mammography, antibiotics and selection criteria for surgery.
authors.affiliation: Academic Surgical Unit, University of Hull, Cottingham, East Riding, UK.
authors.forename: O C
authors.initials: OC
authors.lastname: Iwuagwu
authors.forename: A J
authors.initials: AJ
authors.lastname: Platt
authors.forename: P J
authors.initials: PJ
authors.lastname: Drew
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000639:trends; D000698:Analgesia / Q000379:methods; D004322:Drainage; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D007494:Ireland; D016462:Mammaplasty / Q000639:trends*; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011364:Professional Practice; D012086:Reoperation; D011795:Surveys and Questionnaires; D006113:United Kingdom