Breast Reduction - Patient

Patient

Presentation

The woman afflicted with macromastia presents heavy, enlarged breasts (>500 gm per breast per the Shnur Scale) that sag and cause her chronic pains to the head, neck, shoulders, and back; an oversized bust also causes her secondary health problems, such as poor blood circulation, impaired breathing (inability to fill the lungs with air); chafing of the skin of the chest and the lower breast (inframammary intertrigo); brassière-strap indentations to the shoulders; and the improper fit of clothes.

In the woman afflicted with gigantomastia (>1,000 gm increase per breast), the average breast-volume reduction diminished her oversized bust by three (3) brassière cup-sizes. The surgical reduction of abnormally enlarged breasts resolves the physical symptoms and the functional limitations that a bodily-disproportionate bust imposes upon a woman; thereby it improves her physical and mental health. Afterwards, the woman's ability to comfortably perform physical activities previously impeded by oversized breasts improves her emotional health (self-esteem) by reducing anxiety and lessening psychological depression.

Medical history

The medical history records the woman's age, the number of children she has borne, her breast-feeding practices, plans for pregnancy and nursing of the infant, medication allergies, and tendency to bleeding. Additional to the personal medical information, are her history of tobacco smoking and concomitant diseases, breast-surgery and breast-disease histories, family history of breast cancer, and complaints of neck, back, shoulder pain, breast sensitivity, rashes, infection, and upper extremity numbness.

The physical examination records and establishes the accurate measures of the woman's body mass index, vital signs, the mass of each breast, the degree of inframammary intertrigo present, the degree of breast ptosis, the degree of enlargement of each breast, lesions to the skin envelope, the degree of sensation in the nipple-areola complex (NAC), and discharges from the nipple. Also noted are the secondary effects of the enlarged breasts, such as shoulder-notching by the brassière strap from the breast weight, kyphosis (excessive, backwards curvature of the thoracic region of the spinal column), skin irritation, and skin rash affecting the breast crease (IMF).