Effects of Reduction Mammaplasty Operations on the Spinal Column: Clinical and Radiological Response.

Background: Women with macromastia suffer from bodily disproportions like increased spinal curvature owing to the mass effect caused by severely large breasts. In such cases, the erector spinae muscles generate an overcompensatory pressure to maintain a normal posture, resulting in neck, back, and lumbar pain. This study aimed to objectively show the improvement of physical symptoms after reduction mammaplasty and evaluate psychological and physical changes of patients.

Methods: Pre- and postoperative cervical, thoracic, and lumbar bidirectional (anteroposterior and lateral) radiographs were obtained from 40 patients who underwent reduction mammaplasty. Cervical lordosis, thoracic kyphosis, lumbar lordosis, and lumbosacral angles were evaluated. Body mass index, breast tissue volume, and excised tissue amount were recorded for each patient. Visual Analog Scores (VAS) were used to qualify the severity of neck, back, and lumbar pain, the Nottingham Health Profile (NHP) to evaluate quality of life (QoL), and the Beck Depression Inventory (BDI) to evaluate depression severity.

Results: Cervical lordosis, thoracic kyphosis, lumbar lordosis, and lumbosacral angle improved, and patients' neck, back, and lumbar pain decreased. The positive correlation between the excised glandular tissue amount and the decrease in neck, back, and lumbar pain was reflected in the results of VAS, NHP, and BDI tests. After reduction mammaplasty, depression symptoms caused by macromastia decreased. Parameters of QoL, including physical activity, socialization, fatigue, sleeping, and emotional reactions, significantly improved.

Conclusion: Patients with macromastia should be considered for reduction mammaplasty before the onset of postmenopausal osteoporosis to improve QoL.