title: Breast reduction surgery in Ontario: Changes in practice, 1992 to 2008.
abstract: BACKGROUND
  Symptomatic mammary hypertrophy impacts physical function and patient quality of life. Breast reduction mammoplasty, a surgical procedure performed to reduce breast size, has been used for many years to reduce these symptoms.
  
  
  OBJECTIVE
  To evaluate variations in the surgical practice of breast reduction mammoplasty among women ≥15 years of age (approximately 6.4 million population in 2008) over a 17-year period in Ontario.
  
  
  METHODS
  A population-based, cross-sectional time series analysis was conducted to examine temporal trends in 87,049 breast reduction surgeries performed between January 1, 1992 and December 30, 2008.
  
  
  RESULTS
  Breast reduction rates have been relatively stable over time, with 83 per 100,000 of the female population undergoing breast reduction surgery annually. However, a significant decrease in the rate of inpatient surgeries were observed over the study period (from 69.3 per 100,000 in 1992 to 25.7 per 100,000 in 2008). At the beginning of the study period, the highest annual rates of this procedure were observed among women 21 to 30 years of age (116.6 procedures per 100,000); however, by the end of the observation period, this shifted to women 31 to 50 years of age (109.9 procedures per 100,000). Furthermore, the annual procedure rate among women ≥51 years of age almost doubled, rising from 36.4 procedures per 100,000 in 1992 to 66.6 procedures per 100,000 in 2008. This was likely related to changing demographics and social factors.
  
  
  CONCLUSIONS
  These data suggest that breast reduction mammoplasty will continue to be requested, with an increased proportion of patients who are older and desire improved quality of life and physical function.
authors.affiliation: St Michael's Hospital, Toronto, Ontario; ; King Saud University/King Saud University College of Medicine, Riyadh, Saudi Arabia;
authors.forename: Bisher
authors.initials: B
authors.lastname: Alshanawani
authors.affiliation: King Saud University/King Saud University College of Medicine, Riyadh, Saudi Arabia; ; University of Toronto;
authors.forename: Nawarah
authors.initials: N
authors.lastname: Alarfaj
authors.affiliation: King Saud University/King Saud University College of Medicine, Riyadh, Saudi Arabia;
authors.forename: Feras
authors.initials: F
authors.lastname: Alshomer
authors.affiliation: Applied Health Research Centre (AHRC) Li Ka Shing Knowledge Institute of St Michael's Hospital;
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mamdani
authors.affiliation: Ontario Drug Policy Research Network, Institute For Clinical Evaluative Sciences;
authors.forename: Tara
authors.initials: T
authors.lastname: Gomes
authors.affiliation: Division of Plastic & Reconstructive Surgery, St Michael's Hospital, Toronto, Ontario.
authors.forename: James
authors.initials: J
authors.lastname: Mahoney
keywords: Breast; Canada; Epidemiology; Mammary hypertrophy; Reduction