Article

Abstract

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 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.

Conclusion: 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.

Level of evidence iv: 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 .

Comment in

  • Editor’s invited commentary: Does reduction mammaplasty revert skeletal disturbances in the vertebral column of patients with macromastia? A preliminary study.

    Elowitz EH.Aesthetic Plast Surg. 2014 Feb;38(1):113-114. doi: 10.1007/s00266-013-0215-0. Epub 2013 Oct 3.PMID: 24091490 No abstract available.

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  • Patient-Reported Measurement of Breast Asymmetry Using Archimedes’ Principle in Breast Reduction Mammaplasty: A Retrospective Study.

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    Papanastasiou C, Ouellet JA, Lessard L.Plast Reconstr Surg Glob Open. 2019 Aug 12;7(8):e2324. doi: 10.1097/GOX.0000000000002324. eCollection 2019 Aug.PMID: 31592372 Free PMC article.

MeSH terms

  • adult
  • Body Mass Index
  • Breast / changes*
  • breast / surgery
  • human
  • Hypertrophy / complications*
  • Hypertrophy / surgery*
  • Kyphosis / etiology*
  • Kyphosis / surgery*
  • Lordosis / etiology*
  • Lordosis / surgery*
  • mammaplasty*
  • middle aged
  • Prospective Studies
  • Remission Induction
  • Young Adult

Supplementary concepts

  • gigantomastia

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    • springer
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