title: Breast reduction in adolescents: indication, timing, and a review of the literature.
abstract: BACKGROUND
  Adolescent breast hypertrophy can have long-term negative medical and psychological impacts. In select patients, breast reduction surgery is the best treatment. Unfortunately, many in the general and medical communities hold certain misconceptions regarding the indications and timing of this procedure. Several etiologies of adolescent breast hypertrophy, including juvenile gigantomastia, adolescent macromastia, and obesity-related breast hypertrophy, complicate the issue. It is our hope that this paper will clarify these misconceptions through a combined retrospective and literature review.
  
  
  METHODS
  A retrospective review was conducted looking at adolescent females (≤18 years old) who had undergone bilateral breast reduction surgery. Their preoperative comorbidities, BMI, reduction volume, postoperative complications, and subjective satisfaction were recorded. In addition, a literature review was completed.
  
  
  RESULTS
  34 patients underwent bilateral breast reduction surgery. The average BMI was 29.5 kg/m(2). The average volume resected during bilateral breast reductions was 1820.9 g. Postoperative complications include dehiscence (9%), infection (3%), and poor scarring (6%). There were no cases of recurrence or need for repeat operation. Self-reported patient satisfaction was 97%. All patients described significant improvements in self body-image and participation in social activities. The literature review yielded 25 relevant reported articles, 24 of which are case studies.
  
  
  CONCLUSIONS
  Reduction mammaplasty is safe and effective. It is the preferred treatment method for breast hypertrophy in the adolescent female and may be the only way to alleviate the increased social, psychological, and physical strain caused by this condition.
authors.affiliation: Division of Plastic Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Xue
authors.forename: Erik M
authors.initials: EM
authors.lastname: Wolfswinkel
authors.forename: William M
authors.initials: WM
authors.lastname: Weathers
authors.forename: Chuma
authors.initials: C
authors.lastname: Chike-Obi
authors.forename: Lior
authors.initials: L
authors.lastname: Heller
mesh_terms: D000293:Adolescent; D001416:Back Pain / Q000209:etiology; D001828:Body Image; D001940:Breast / Q000473:pathology* / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000523:psychology / Q000601:surgery; D016462:Mammaplasty / Q000009:adverse effects / Q000523:psychology; D019547:Neck Pain / Q000209:etiology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D058992:Social Participation; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors
keywords: Adolescent; Breast hypertrophy; Breast reduction; Reduction mammaplasty