title: Hypertrophy of the breast: a problem of beauty or health?
abstract: BACKGROUND
  Despite the complex health burden for women with breast hypertrophy, medical directors of health insurance companies are not convinced that this procedure is of medical benefit for patients. Therefore, coverage of cost by the health insurance companies is no longer guaranteed. The purpose of this study is to evaluate the influence of breast weight on the physical and psychological morbidity of women and to prove the medical necessity of reduction mammaplasty.
  
  
  METHODS
  We performed a cohort study of 50 women with various breast sizes, a mean age of 28 years (range 20-40 years), and a body mass index (BMI) <25. Breast weight was measured, the spine was investigated by magnetic resonance imaging (MRI), and a spine score of clinical symptoms was assessed. The Beck Depression Inventory (BDI) was used to evaluate psychological impairment. Pathological findings have been correlated with breast weight, and the risk of developing a morphological or psychological disorder independence of the breast weight was calculated.
  
  
  RESULTS
  The incidence of degenerative spine disorders and the extent of depressive symptoms are correlated with increasing breast weight.
  
  
  CONCLUSIONS
  The data show that high breast weight has a negative influence on the physical and psychological morbidity of women. This objective evidence in support of the medical necessity of reduction mammaplasty should guide managed care organizations' methods for determining coverage for reduction mammaplasty.
authors: Department of Plastic and Reconstructive Surgery, Hospital Rudolfstiftung, Vienna, Austria. heike.benditte-klepetko@wienkav.at
authors: Heike
authors: H
authors: Benditte-Klepetko
authors: Valerie
authors: V
authors: Leisser
authors: Tatjana
authors: T
authors: Paternostro-Sluga
authors: Monika
authors: M
authors: Rakos
authors: Siegfried
authors: S
authors: Trattnig
authors: Thomas
authors: T
authors: Helbich
authors: Michael
authors: M
authors: Schemper
authors: Maria
authors: M
authors: Deutinger
mesh_terms: D000328:Adult; D001504:Beauty; D015992:Body Mass Index; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000191:economics / Q000601:surgery; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000191:economics / Q000601:surgery; D007359:Insurance, Surgical; D016462:Mammaplasty / Q000191:economics