Abstract Title: Controversy Regarding Reduction Mammaplasty in Young Patients: A Case of Breast Reduction in a 19-Year-Old

Background: Previously, breast reductions have rarely been performed on young women, largely due to concerns regarding postoperative regrowth of the breasts and decreased breastfeeding ability, among others. However, many younger patients suffer from the same symptoms as adults who pursue reduction mammaplasty and could benefit from the procedure. Previous research has shown high long-term satisfaction rates in patients who underwent reduction mammaplasty, even in adolescence and young adulthood. These factors have led to much controversy regarding the appropriateness of breast reduction in young patients.

Case Presentation: Here, we present the successful use of reduction mammaplasty in a 19-year-old female who was five feet four inches tall, 160 pounds, and who wore a 40 I cup size bra. The patient presented with back, neck, and shoulder pain along with inframammary rashes resulting from macromastia. Following ultrasound and physical exam, no additional problems associated with her breasts were identified. However, she reported that her paternal aunt and grandmother had breast cancer, and that her mother had undergone reduction mammaplasty years prior. Bilateral reduction mammaplasty was determined to be a medical necessity. The patient was informed of the risks associated with the procedure, and she chose to proceed with surgery. The patient did not suffer any complications, had very good wound healing, and was satisfied with the result.

Discussion: Meta-analysis maintains that reduction mammaplasty can reduce breastfeeding ability and that postoperative breast growth can negate the positive effects of the procedure. Though postoperative regrowth of the breasts rarely requires surgical correction, concerns are warranted as secondary operations are challenging, complex, and carry much higher complication rates than primary reduction mammaplasties. Despite the risks, however, many younger patients can receive substantial benefit from breast reduction. Therefore, decisions to perform surgery are best made on a case-by-case basis. Surgeons must be sufficiently informed of this controversy prior to surgical consult so informed consent can be obtained. Furthermore, young patients must not be denied the opportunity to discuss reduction mammaplasty as a treatment option so long as they have reasonable goals and adequate comprehension of the potential risks.