November 28th, 2011 by RamonaBatesMD in Research
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This article (full reference below) on the additional benefits an individual gains from having a reduction mammoplasty (RM) has been published online ahead of print. The authors performed a systemic review of the literature focusing on functional outcomes after RM with regard to physical and psychological symptom improvement.
The authors performed a systematic review of the English literature using PUBMED for the period between 1977 to 2010. Studies were chosen that addressed the physical and psychological benefits of RM using a validated questionnaire.
The authors note that nearly eighty thousand breast reductions were performed in 2009. For insurance coverage in the United States a woman seeking breast reduction must have complaints of physical symptoms (i.e., Read more »
*This blog post was originally published at Suture for a Living*
November 16th, 2011 by John Di Saia, M.D. in Opinion, True Stories
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Jeanette’s story:
For as long as I can remember my nickname has been ‘Jen Big Boobs’. Friends joke that the first thing they see when I walk through the door is my chest. I know they mean no harm – just as I know that my husband, Steve, adores them – but it’s reached the point where they have got to go. They simply dominate my life. Whether I’m trying to get comfy in bed or walking down the street I can’t forget them for a moment. They are always there, getting in the way of everything I do. In primary school I was the first in class to wear a bra. So when my pals changed in the classroom for PE, I’d change in the loos. Big boobs weren’t a huge surprise – they run in my family. But it was embarrassing and I didn’t like being different. They’ve singled me out for loads of attention. Buying bras has always been and still is a nightmare. I have to order specially-made ones that are ugly and cost up to £50. By the time I was 20 I’d already gone to see my GP about a reduction operation. He was sympathetic but said I was too young for surgery.
Steve’s story:
I love my wife’s big boobs and don’t want them reduced. I don’t mind admitting that Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
September 13th, 2011 by RamonaBatesMD in Opinion, Research
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Many women with large breast and weight issues seek breast reduction. I was taught to encourage them to lose weight first. Now there is a very small study that backs this up (full reference below).
The American Society of Plastic Surgeons issued a press release entitled “Breast Reduction and Bariatric Surgery—Which Should Be Done First?” and provided the answer “Final Results May Be Better When Weight Loss Comes First.” I agree, but find it odd that such a small study was published. There should have been more patients included.
Jeffrey A. Gusenoff, MD, and colleagues reviewed two groups of patients who sought consultation for body contouring surgery August of 2008 and February of 2010 after massive weight loss (defined as a weight loss of greater than 50 pounds).
Group I (n=15) included Read more »
*This blog post was originally published at Suture for a Living*
March 31st, 2011 by John Di Saia, M.D. in Opinion
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For years I have avoided Medicare breast reductions for a number of reasons:
(1) Poor pay for hours of work. An average breast reduction when done to a high standard usually takes 3-4 hours. I do not staple the closure.
(2) Medicare patients due to their age are at higher risk for wound healing problems.
(3) 90 day global fee period – These patients routinely need follow-up care and that care is not billable.
Recently I ignored my better judgment and performed the operation for a lady in whom back pain (ICD-9 724.5) and back surgery had been long term problems. She also had a pretty nasty rash (ICD-9 692.89 Dermatitis and eczema [in the infra-mammary fold]) under her right breast that just wouldn’t go away. These of course were all in addition to the usual diagnosis of large breasts (ICD-9 611.1 Hypertrophy of breast.)
Medicare showed me yet another reason for my hesitation to do these cases when they denied payment for the operation saying it was not medically indicated. They will probably pay on appeal, but the thought that I should have to appeal the case adds insult to injury.
*This blog post was originally published at Truth in Cosmetic Surgery*
