Does reduction mammaplasty revert skeletal disturbances in the vertebral column of patients with macromastia? A preliminary study.
BACKGROUND
Enlarged breasts are associated with many physical and psychological symptoms. It is important to use objective criteria in documenting physical changes of a patient's body due to enlarged breasts and the benefits of surgery. This preliminary study aimed to determine whether the reduction mammaplasty procedure changes the angles of cervical lordosis, thoracic kyphosis, and lumbar lordosis.


METHODS
The study population consisted of 22 patients who underwent breast reduction surgery. All the patients had lateral cervicothoracolumbar radiographs taken preoperatively and at least 2 months postoperatively. Cervical lordosis, thoracic kyphosis, and lumbar lordosis angles, as well as sagittal balance, were examined. The body mass index (BMI), breast tissue volume, and excised tissue amount of each patient were recorded.


RESULTS
All the patients had increased cervical lordosis and thoracic kyphosis angles preoperatively, and the angles were significantly decreased postoperatively. Of the 22 patients, 7 had decreased and 8 had increased lumbar lordosis angles. All the lordosis angles showed significant improvement at the last examination. Seven patients had disturbed sagittal balance preoperatively, and all had normal sagittal balance postoperatively. Preoperative total breast tissue volume was positively correlated with the differences in cervical lordosis angles, BMI, preoperative cervical lordosis angles, and cervical lordosis angles.


CONCLUSIONS
Hypertrophic breasts are not only a cosmetic but also a functional problem complicated by pathologic conditions in the vertebral column such as increased cervical lordosis, thoracic kyphosis, and increased or decreased lumbar lordosis. Breast reduction may improve these pathologic angles. Reducing the nonphysiologic weight of enlarged breasts located anterior to the main axis of the body may correct pathologic angulation and disturbed sagittal balance of the vertebral column.


METHODS
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Abant Izzet Baysal University, Tip Fakultesi, Plastic Cerrahi AD, Golkoy, 14000, Bolu, Turkey. furkanerolkarabekmez@yahoo.com.
Furkan Erol
FE
Karabekmez
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Abant Izzet Baysal University, Tip Fakultesi, Plastic Cerrahi AD, Golkoy, 14000, Bolu, Turkey.
Ali
A
Gokkaya
Department of Orthopedic Surgery, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
Cengiz
C
Isik
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Abant Izzet Baysal University, Tip Fakultesi, Plastic Cerrahi AD, Golkoy, 14000, Bolu, Turkey.
Ibrahim
I
Saglam
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Abant Izzet Baysal University, Tip Fakultesi, Plastic Cerrahi AD, Golkoy, 14000, Bolu, Turkey.
Fatih Burak
FB
Efeoglu
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Abant Izzet Baysal University, Tip Fakultesi, Plastic Cerrahi AD, Golkoy, 14000, Bolu, Turkey.
Metin
M
Gorgu
D000328:Adult; D015992:Body Mass Index; D001940:Breast / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D006984:Hypertrophy / Q000150:complications* / Q000601:surgery*; D007738:Kyphosis / Q000209:etiology* / Q000601:surgery*; D008141:Lordosis / Q000209:etiology* / Q000601:surgery*; D016462:Mammaplasty; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D055815:Young Adult