1
|
Koussayer B, Taylor J, Warner J, Alkaelani MT, Blount T, Wainwright D, Threet A, Le NK, Whalen K, Coughlin E, Mhaskar R, Kuykendall L. Breastfeeding Ability After Breast Reductions: What does the Literature Tell us in 2023? Aesthetic Plast Surg 2024; 48:1142-1155. [PMID: 37845550 DOI: 10.1007/s00266-023-03690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Reduction mammaplasties are routinely performed on women of child-bearing age, yet there still exists some uncertainty regarding a patient's ability to breastfeed following the procedure. This is due to inconsistent definitions of "successful" breastfeeding, a variety of pedicles implemented, and inadequate follow-up in the published literature. Our aim was to summarize the current data and provide clear recommendations for counseling patients on expected breastfeeding outcomes following reduction mammaplasty. METHODS A systematic review and meta-analysis in accordance with the PRISMA guidelines was conducted. We included papers that reported proportion of breastfeeding ability following reduction mammaplasty. RESULTS We identified 33 papers that met our inclusion criteria. We found that women who undergo reduction mammaplasty are at a 3.5 times increased odds of not being able to breastfeed compared to controls. Overall, reduction mammaplasty patients have a breastfeeding success rate of 62%. The breastfeeding success rate for patients with inferior pedicles was 64%, superior pedicles was 59%, and lateral pedicles was 55%. No conclusions could be drawn regarding medial, central, vertical, and horizontal pedicles on breastfeeding ability. CONCLUSION Current data suggest that women undergoing reduction mammaplasty have an increased odds of unsuccessful breastfeeding when compared to similar women who have not undergone the procedure. Based on the current literature, pedicle type does play a role in rate of breastfeeding success, although there is a need for further research on the aforementioned pedicles. Physicians should be aware of the likelihood of successful breastfeeding following reduction mammaplasty so that patients can be more thoroughly counseled prior to a decision for surgery. LEVEL OF EVIDENCE I 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 .
Collapse
Affiliation(s)
- Bilal Koussayer
- University of South Florida Health Morsani College of Medicine, 560 Channelside Dr, Tampa, FL, 33602, USA.
| | - Justin Taylor
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA
| | - Jamie Warner
- University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32610, USA
| | | | - Taylor Blount
- Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL, 32304, USA
| | - D'Arcy Wainwright
- Department of Plastic Surgery, University of South Florida,, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
| | - Abby Threet
- Department of Plastic Surgery, University of South Florida,, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
| | - Nicole K Le
- Department of Plastic Surgery, University of South Florida,, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
| | - Kristen Whalen
- Department of Plastic Surgery, University of South Florida,, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
| | - Emily Coughlin
- University of South Florida Health Morsani College of Medicine, 560 Channelside Dr, Tampa, FL, 33602, USA
| | - Rahul Mhaskar
- University of South Florida Health Morsani College of Medicine, 560 Channelside Dr, Tampa, FL, 33602, USA
| | - Lauren Kuykendall
- Department of Plastic Surgery, University of South Florida,, 2 Tampa General Circle, 7th Floor, Tampa, FL, 33606, USA
| |
Collapse
|
2
|
Seswandhana R, Anzhari S, Dachlan I. A successful breastfeeding after vertical scar reduction mammaplasty with superior pedicle: A case report. Ann Med Surg (Lond) 2020; 60:600-603. [PMID: 33304571 PMCID: PMC7708693 DOI: 10.1016/j.amsu.2020.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Most of patients undergo reduction mammaplasty for aesthetic or therapeutic reasons without consider the effect on breastfeeding function. Vertical scar mammaplasty with superior pedicle is expected to be a breast reduction procedure that can keep maintain the function of breastfeeding. This is the first recorded report of breastfeeding after vertical scar reduction mammaplasty with superior pedicle in Indonesia. Presentation of case A 23 years old woman presented to the outpatient clinic with enlargement of both breast for 3 years. Physical examination showed bilateral breast enlargement. No tenderness, nodules, nor axillary lymph node enlargement were found. The patient was managed with vertical scar mammaplasty with superior pedicle. The patient was followed up with complication of skin excess and scarring on the bilateral submammary folds. We performed excision and resection procedures to eliminate the skin excess and scars without further complications. The patient was married and gave birth to her first and second child after two and five years following mammaplasty. The patient was able to provide exclusive breastfeeding for both of her children. Discussion Vertical scar mammaplasty with superior pedicle surgery is a surgical technique that combines a superior pedicle for the areola and performs a central-inferior quadrant resection for breast reduction. It only takes the tissue and glands that are located in the lower quadrant and still maintains the surrounding tissue and glands. This technique also maintains the integrity of nipple-areola complex (NAC) which also important in the lactation process Conclusion Vertical scar mammaplasty with superior pedicle can be one of the superior techniques in breast reduction which can maintain the breastfeeding function thereby increasing patient satisfaction. Breastfeeding after Vertical Scar Reduction Mammaplasty with Superior Pedicle: This procedure only takes the tissue and glands that are located in the lower quadrant. By preserving the superior pedicle it can maintains the integrity of nipple-areola complex (NAC). Keep the breastfeeding function thereby increasing patient satisfaction.
Collapse
Affiliation(s)
- Rosadi Seswandhana
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Sharfan Anzhari
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Ishandono Dachlan
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
| |
Collapse
|