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Which surgery should come first?

Article-Which surgery should come first?

Rochester, N.Y. — Very obese women considering both bariatric and breast-reduction surgery should be advised that optimal results are achieved when the weight-loss procedure is done first, Medical News Today reports.

Results of a University of Rochester Medical Center study suggest that while initial breast reduction has some benefits, women may be disappointed with the appearance of their breasts after massive weight loss.

Researchers analyzed patient satisfaction and other outcomes in severely obese women who had massive weight loss of more than 50 pounds. All but one of the women achieved the weight loss as a result of bariatric surgery. The study included two groups, one comprising 15 women who underwent breast-reduction surgery before massive weight loss and 14 who had no breast-reduction surgery before weight loss. All of the women who underwent reduction mammaplasty thought their breasts looked better after the operation. In addition, most felt better able to exercise and to lose weight on their own after breast-reduction surgery. However, all 15 women needed bariatric surgery to achieve their weight-loss goals. Bariatric surgery was followed by further reductions in breast size.

After massive weight loss, 86 percent of the women who previously had had reduction mammaplasty thought their breasts looked worse. About half of the women planned to have further surgery to improve the appearance of their breasts. Others said they would have further surgery if it was covered by insurance and, if giving advice to a friend, said they would recommend losing weight before undergoing breast-reduction surgery.

Of the women who did not undergo reduction mammaplasty, 71 percent felt the appearance of their breasts was worse after bariatric surgery. Half said they planned to have breast-reduction surgery, while more said they would if they could afford it.

The study appears in the September issue of Plastic and Reconstructive Surgery.

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