Reduction Mammoplasty for the Plastic Surgeon: A Clinical Case

Aditya Sood, MD, MBA; Mark S. Granick, MD


November 23, 2015

Case Presentation

A 43-year-old woman presents to the office with complaints of large breasts that are causing her significant back and neck pain and interfering with her activities of daily living. She has difficulty fitting into clothes and has been treated with topical medications for rash and intertrigo in her infra-mammary regions on multiple occasions. She has been evaluated by a chiropractor for back pain and has been diagnosed with painful kyphosis, refractory to conservative therapeutic measures. She is requesting bilateral breast reduction mammoplasty. The patient has no other significant medical history.

Physical Examination and Diagnosis

The patient was found to have significant bilateral breast macromastia with grade 3 advanced ptosis with the nipple-areolar complex (NAC) below the inframammary fold (IMF) and at the level of maximum breast projection (Figure 1).

Figure 1. Preoperative photo of breast macromastia. Image courtesy of Mark S. Granick, MD.

Her body mass index is 38 kg/m2. She demonstrates grooving in the shoulder strap region. Review of records demonstrates that the patient has not responded to a 3-month trial of therapeutic measures, including nonsteroidal anti-inflammatory drugs, physical therapy, exercises, and posturing maneuvers. Her most recent mammogram was reviewed and noted to be negative for any masses or suspicious lesions.


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