title: Self-esteem and functional capacity outcomes following reduction mammaplasty.
abstract: BACKGROUND
  Both physical health and psychosocial outcomes are important issues in the evaluation of medical treatment. Women with breast hypertrophy may suffer from low self-esteem and reduced functional capacity because of the size of their breasts.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the impact of reduction mammaplasty on self-esteem and functional capacity in patients with breast hypertrophy.
  
  
  METHODS
  One hundred patients with breast hypertrophy who ranged in age from 18 to 55 years and who had undergone no previous mammary surgery were selected from the Plastic Surgery Outpatient Clinic of the Federal University of São Paulo (UNIFESP-EPM). They were randomly allocated into two groups (A and B) of 50 patients each. Patients from group A were submitted for reduction mammaplasty while those from group B were placed on the waiting list and used as a control group. At the beginning of the study, all patients were interviewed to collect clinical and demographic data and to have their self-esteem and functional capacity measured. Two Brazilian-validated versions of quality of life measurement instruments were chosen: the Rosenberg Self-Esteem Scale and Rolland-Morris (to assess functional capacity). A visual analog scale (VAS) was used to evaluate pain intensity. Six months after the beginning of the study, these instruments were again administered to both groups.
  
  
  RESULTS
  Forty-six out of 50 patients from each group (A and B) completed the study. The mean age of group A was 31.6 years (SD, 11 yrs), and that of group B was 32.3 years (SD, 10 yrs). The mean weight of removed breast tissue from group A patients was 1052 g (SD, 188 g). A decrease on the score of Rosenberg Self-Esteem Scale of patients from group A indicated an improvement of self-esteem (P < .001). Functional capacity had improved 6 months after reduction mammaplasty (group A) as compared to the control group. Intensity of pain evaluated by the VAS in the lower back region decreased from 5.7 to 1.3.
  
  
  CONCLUSIONS
  Reduction mammaplasty improved self-esteem and functional capacity and relieved pain in the lower back region in patients with breast hypertrophy.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, and Division of Rheumatology (MQ), Federal University of São Paulo, São Paulo, Brazil. msabino@uol.com.br
authors.forename: Miguel
authors.initials: M
authors.lastname: Sabino Neto
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Demattê
authors.forename: Marcia
authors.initials: M
authors.lastname: Freire
authors.forename: Elvio Bueno
authors.initials: EB
authors.lastname: Garcia
authors.forename: Marina
authors.initials: M
authors.lastname: Quaresma
authors.forename: Lydia M
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001940:Breast / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology; D016462:Mammaplasty / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function / Q000502:physiology; D012107:Research Design; D012649:Self Concept; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult