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Reduction mammoplasty

Key sources
The following summarized guidelines for the evaluation and management of reduction mammoplasty are prepared by our editorial team based on guidelines from the American Society of Plastic Surgeons (ASPS 2022) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS/ASB/BSBR 2018).
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Guidelines

1.Diagnostic procedures

Breast tissue histopathology: send breast tissue removed from postmenarche female patients undergoing reduction mammaplasty for pathologic evaluation.
B
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2.Perioperative care

Preoperative evaluation: elicit a full breast history and physical examination in females undergoing esthetic breast surgery.
E
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  • Postoperative pain management

  • Postoperative antibiotic therapy

3.Surgical interventions

Indications for surgery: offer reduction mammaplasty surgery as first-line therapy over nonoperative therapy in postmenarche female patients presenting with breast hypertrophy based solely on the presence of multiple symptoms rather than resection weight.
A

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  • Technical considerations for surgery

4.Patient education

Preoperative counseling: counsel postmenarche patients with symptomatic breast hypertrophy that the following factors increase the risk of complications after reduction mammaplasty:
age > 50 years
BMI > 35 kg/m²
chronic corticosteroid use
B

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  • Preoperative smoking cessation

5.Follow-up and surveillance

Follow-up: do not obtain routine breast imaging after esthetic breast surgery.
D
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