title: Functional capacity and postural pain outcomes after reduction mammaplasty.
abstract: BACKGROUND
  Neck, shoulder, and lower back pain and reduction of functional capacity can be caused by breast hypertrophy. Reduction mammaplasty appears to improve these aspects. After a systematic review of the literature, no scientific evidence was found to confirm this hypothesis. The authors' objective was to evaluate the impact of reduction mammaplasty on pain and functional capacity of patients with mammary hypertrophy.
  
  
  METHODS
  One hundred patients with mammary hypertrophy, between 18 and 55 years old, with no previous mammary surgery, were consecutively selected from the Plastic Surgery Outpatient Clinic of the Universidade Federal de São Paulo-Escola Paulista de Medicina and randomly allocated into two groups. Group A (n = 50) underwent mammaplasty reduction immediately, whereas group B patients (n = 50) were placed on a waiting list (control group). All patients were interviewed for clinical and demographic data and evaluated to measure pain and functional capacity. To measure shoulder, neck, and lower back pain, a visual analogue scale (0 = no pain, 10 = unbearable pain) was used. The Stanford Health Assessment Questionnaire (HAQ-20), Brazilian validated version (0 = best, 3 = worst), was applied to assess functional capacity. Pain and functional capacity were measured at baseline and 6 months after surgery.
  
  
  RESULTS
  Forty-six of 50 patients, from both groups, completed the study. The mean (+/-SD) patient age in groups A and B was 31.6 +/- 11 and 32.3 +/- 10 years, respectively. The mean breast tissue weight was 1052 +/- 188 g. Functional capacity in group A was improved 6 months after reduction mammaplasty, compared with group B (control), in the following aspects: getting dressed, getting up, walking, maintaining personal hygiene, reaching, and grasping objects. The mean pain intensity dropped in the lower back, from 5.7 to 1.3; in the shoulders, from 6.1 to 1.1; and in the neck, from 5.2 to 0.9.
  
  
  CONCLUSIONS
  Reduction mammaplasty improved functional capacity and relieved pain in the lower back, shoulders, and neck of patients with mammary hypertrophy.
authors.affiliation: São Paulo, Brazil From the Division of Plastic Surgery, Department of Surgery, Federal University of São Paulo.
authors.forename: Marcia
authors.initials: M
authors.lastname: Freire
authors.forename: Miguel Sabino
authors.initials: MS
authors.lastname: Neto
authors.forename: Elvio Bueno
authors.initials: EB
authors.lastname: Garcia
authors.forename: Marina Rodrigues
authors.initials: MR
authors.lastname: Quaresma
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology; D001940:Breast / Q000473:pathology* / Q000601:surgery*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D016014:Linear Models; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome