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Background: Reduction mammaplasty is often performed on obese women. With the rise in bariatric procedures, secondary changes to breast contour are increasing. This study aims to investigate the temporal relationships of breast contour satisfaction with weight status.

Methods: One hundred ninety patients were examined. Patient demographics, comorbidities, body mass index, surgical history, and weight loss method used were evaluated. Patients who underwent reduction mammaplasty before massive weight loss were selected and administered a telephone survey (group I). Patients who did not undergo breast surgery before massive weight loss were selected as a control group (group II).

Results: Of the 15 patients (7.9 percent) in group I, 14 completed the survey (93 percent). For group I, all patients felt the appearance of their breasts improved after reduction (p < 0.001) but felt appearance worsened or stayed the same after weight loss (p = 0.003). Seventy-one percent of patients were able to exercise more and 64 percent were able to lose weight on their own because of their reduction. For group II, 79 percent of patients felt the appearance of their breasts worsened or stayed the same after massive weight loss (p = 0.03).

Conclusions: Most reduction patients before massive weight loss are glad they had the reduction and become more active but ultimately needed bariatric surgery to accomplish weight loss goals and are dissatisfied with breast contour following massive weight loss. Thus, patients who are considering bariatric procedures should be encouraged to pursue that operation before proceeding with reduction mammaplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

(C)2011American Society of Plastic Surgeons