The Impact of Reduction Mammaplasty on Back Pain and Posture in Patients with Macromastia: A Systematic Review and Meta-Analysis.

BACKGROUND

This systematic review and meta-analysis was performed to evaluate the impact of reduction mammaplasty (RM) on back pain and postural changes in patients with macromastia.

METHODS

A comprehensive literature search (using PubMed, Google Scholar, Embase, and Scopus) was conducted in November of 2024 according to the 2020 PRISMA statement. Both prospective and retrospective studies examining the effects of RM on back pain and posture were included. Primary outcomes were changes in back pain, spinal alignment (thoracic kyphosis and lumbar lordosis), and postural control.

RESULTS

A total of 47 studies met the inclusion criteria for systematic review, with 25 contributing to different meta-analyses ( n = 4677). The mean age was 38.6 ± 3.0 years, the mean body mass index was 27.57 ± 2.06 kg/m 2 , and the mean follow-up was 27.4 ± 25.5 months. All studies assessing back pain reported relief after RM. A meta-analysis of 7 studies ( n = 393) using the visual analog scale showed a significant reduction in back pain (mean difference, 5.01 [95% CI, 3.11 to 6.91]; P < 0.01). A separate quantitative analysis of 12 studies ( n = 1380) using a dichotomous end point (improvement in back pain versus no improvement) found that 90% of patients experienced significant back pain relief (95% CI, 86% to 93%). Thoracic kyphosis, assessed in 4 studies ( n = 126), improved significantly (mean difference, 1.5 degrees [95% CI, 0.23 to 2.76 degrees]; P = 0.02), whereas changes in lumbar lordosis ( n = 126) were less consistent (mean difference, 0.26 degrees [95% CI, -0.07 to 0.60 degrees]; P = 0.13). Postural control data are exploratory due to the limited number of comparable studies.

CONCLUSIONS

RM appears to be an effective intervention for alleviating chronic back pain and improving thoracic kyphosis in patients with macromastia. Further research is needed to clarify its effects on postural control.