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Jamie Burt , MBBS,FRACS
*
*
*Misinformation –patients motivated by
cosmetic concerns, appearance
*Misperception- large breasts don’t cause
significant adverse physical symptoms
*Ignorance- real motivations leading women to
seek breast reduction
*Prejudice- one person’s symptoms are more
deserving than another ( pain from Arthritis of
the hip/knee is more valid than pain from large
breasts)
*
*Published peer reviewed research evidence
which documents the true story about women
seeking breast reduction surgery
*
*2013/2014
*Approx. 4000 bilateral breast reductions/year
in Australia
*900 in Victoria
*Stable ( no significant increase in numbers in
recent years)
*
*Age ranges from 16 to 70 years
*Major group 35-60 years
*Smaller group 25-35 years
*Vast majority of women in working years ( vast
majority are actively engaged in work force at
time of seeking advice)
*
*50-59= 35%
*40-49=25%
*30-39=25%
*20-29=5%
*60-69=5%
*
*Back Pain 88%
*Neck Pain 82%
*Shoulder grooves 88%
*Rashes under breast 46%
*Headache 64%
*Exercise intolerance 80%
*Lack of self esteem 88%
*Poor posture 87%
*
*Neck pain
*Back pain
*Shoulder pain, strap marks
*Headaches
*Poor posture
*Rashes, infections under breasts
*Inability to exercise ,exercise intolerance
*Humiliation –work, socially, buying clothes,
exercising, attending commitments with children
*
*Statistically significant improvement in all symptoms is
seen in all patient groups
*Reproduced in multiple studies which document –
symptom reduction
*Resolution of pain
*Increased exercise tolerance
*Objectively documented improved posture (small
studies but xray studies show improved spinal angles)
*Improved lung function (inspiratory capacity, maximal
voluntary ventilation, peak expiratory flow rate )
*
*My practice 97% satisfaction
*92-97% - symptoms completely resolved or
significantly improved in multiple published
research studies
*
*In addition to well documented improvements
in musculoskeletal pain
*Functional improvements in headaches, sleep
and breathing
*Psychological benefits – significant –
statistically significant improvements is self
esteem, sexual function, decreased reported
levels of anxiety and depression
*
2 broad categories of breast reductions
performed
1.Inverted T ( anchor type) scar pattern – inferior
pedicle,central mound,superomedial pedicle
2. Vertical techniques (lollipop )- no
inframammary scar -
superior,superomedial,lateral pedicle
*
*Results from both techniques equal in terms of
functional outcomes
*The purported benefits of vertical techniques
are “reduced scar burden”
*Only issue with this is patient do not report
scar burden as a concern – both techniques
have extremely high satisfaction ratings
*
*Interestingly whilst there is statistical
evidence the greater the weight of breast
tissue reduced the greater the benefit even
smaller volume reductions ( 250g /side) result
in significant improvement in symptoms
*
*
* What is normal?- The most recent ABS data
suggests less than 40% of women who have not
had a breast reduction breastfeed their babies
for 3months and only 15% make it to 6months .
*The World Health Organistation recommends
exclusive breast feeding for 6 months after
birth (ie. only 15 % of Australian women reach
that target). Australia rates well compared
with other countries.
*
*Multiple studies published looking at breast
feeding after breast reduction (although small
patient numbers)
*Report 60-77% of women wishing to breast feed
after a variety of techniques were able to
*Only Australian data 18/19 patients were able
to lactate after breast reduction
*
*In fact one study reports in women who already
had experience with breast feeding their
capacity to feed increased after breast
reduction
*
*Outcomes for breast feeding after breast
reduction mirror findings in the general
population
*Critical elements are
*Encouragement from your doctors
*Access to quality enthusiastic support services
( lactation advisor)
*
*
It appears breast reduction significantly reduces
breast cancer risk
Epidemiological study of 33,000 Scandinavian women
who had breast reduction showed 28% less than
expected incidence of breast cancer.
In the group of women over 50 years,43% reduced
incidence of expected cases of breast cancer.
Increased breast cancer risk is absolutely not an
indication for breast reduction but it is reassuring
that having a reduction likely lessens your risk
*
*Issues can arise with mammographic
appearances of the breast tissue after breast
reduction
*All women over 40 years should have
mammogram preoperatively ( pick any
unsuspected issues)
*Post op mammogram as a routine 12months
postop
*
*Breast reduction is a very misunderstood and
misrepresented procedure
*Patients motivations for seeking surgery are
overwhelmingly physical symptoms ( pain)
*Procedure is well documented to resolve patients
primary symptoms ( musculoskeletal)
*Desirable side effects – functional gains in under
appreciated areas- psychosocial health, exercise
tolerance , respiratory function, decreased breast
cancer risk
*Does not preclude chance to breast feed
http://www.breastreductionclinic.com.au

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Breast reduction Presentation

  • 1. Jamie Burt , MBBS,FRACS *
  • 2. * *Misinformation –patients motivated by cosmetic concerns, appearance *Misperception- large breasts don’t cause significant adverse physical symptoms *Ignorance- real motivations leading women to seek breast reduction *Prejudice- one person’s symptoms are more deserving than another ( pain from Arthritis of the hip/knee is more valid than pain from large breasts)
  • 3. * *Published peer reviewed research evidence which documents the true story about women seeking breast reduction surgery
  • 4. * *2013/2014 *Approx. 4000 bilateral breast reductions/year in Australia *900 in Victoria *Stable ( no significant increase in numbers in recent years)
  • 5. * *Age ranges from 16 to 70 years *Major group 35-60 years *Smaller group 25-35 years *Vast majority of women in working years ( vast majority are actively engaged in work force at time of seeking advice)
  • 7. * *Back Pain 88% *Neck Pain 82% *Shoulder grooves 88% *Rashes under breast 46% *Headache 64% *Exercise intolerance 80% *Lack of self esteem 88% *Poor posture 87%
  • 8. * *Neck pain *Back pain *Shoulder pain, strap marks *Headaches *Poor posture *Rashes, infections under breasts *Inability to exercise ,exercise intolerance *Humiliation –work, socially, buying clothes, exercising, attending commitments with children
  • 9. * *Statistically significant improvement in all symptoms is seen in all patient groups *Reproduced in multiple studies which document – symptom reduction *Resolution of pain *Increased exercise tolerance *Objectively documented improved posture (small studies but xray studies show improved spinal angles) *Improved lung function (inspiratory capacity, maximal voluntary ventilation, peak expiratory flow rate )
  • 10. * *My practice 97% satisfaction *92-97% - symptoms completely resolved or significantly improved in multiple published research studies
  • 11. * *In addition to well documented improvements in musculoskeletal pain *Functional improvements in headaches, sleep and breathing *Psychological benefits – significant – statistically significant improvements is self esteem, sexual function, decreased reported levels of anxiety and depression
  • 12. * 2 broad categories of breast reductions performed 1.Inverted T ( anchor type) scar pattern – inferior pedicle,central mound,superomedial pedicle 2. Vertical techniques (lollipop )- no inframammary scar - superior,superomedial,lateral pedicle
  • 13. * *Results from both techniques equal in terms of functional outcomes *The purported benefits of vertical techniques are “reduced scar burden” *Only issue with this is patient do not report scar burden as a concern – both techniques have extremely high satisfaction ratings
  • 14. * *Interestingly whilst there is statistical evidence the greater the weight of breast tissue reduced the greater the benefit even smaller volume reductions ( 250g /side) result in significant improvement in symptoms
  • 15. *
  • 16. * * What is normal?- The most recent ABS data suggests less than 40% of women who have not had a breast reduction breastfeed their babies for 3months and only 15% make it to 6months . *The World Health Organistation recommends exclusive breast feeding for 6 months after birth (ie. only 15 % of Australian women reach that target). Australia rates well compared with other countries.
  • 17. * *Multiple studies published looking at breast feeding after breast reduction (although small patient numbers) *Report 60-77% of women wishing to breast feed after a variety of techniques were able to *Only Australian data 18/19 patients were able to lactate after breast reduction
  • 18. * *In fact one study reports in women who already had experience with breast feeding their capacity to feed increased after breast reduction
  • 19. * *Outcomes for breast feeding after breast reduction mirror findings in the general population *Critical elements are *Encouragement from your doctors *Access to quality enthusiastic support services ( lactation advisor)
  • 20. *
  • 21. * It appears breast reduction significantly reduces breast cancer risk Epidemiological study of 33,000 Scandinavian women who had breast reduction showed 28% less than expected incidence of breast cancer. In the group of women over 50 years,43% reduced incidence of expected cases of breast cancer. Increased breast cancer risk is absolutely not an indication for breast reduction but it is reassuring that having a reduction likely lessens your risk
  • 22. * *Issues can arise with mammographic appearances of the breast tissue after breast reduction *All women over 40 years should have mammogram preoperatively ( pick any unsuspected issues) *Post op mammogram as a routine 12months postop
  • 23. * *Breast reduction is a very misunderstood and misrepresented procedure *Patients motivations for seeking surgery are overwhelmingly physical symptoms ( pain) *Procedure is well documented to resolve patients primary symptoms ( musculoskeletal) *Desirable side effects – functional gains in under appreciated areas- psychosocial health, exercise tolerance , respiratory function, decreased breast cancer risk *Does not preclude chance to breast feed http://www.breastreductionclinic.com.au