Outcome for patients with bulimia and breast hypertrophy after reduction mammaplasty

R. E. Kreipe, A. G. Lewand, C. P. Dukarm and E. H. Caldwell
Strong Children's Research Center, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, NY, USA.

OBJECTIVES: To determine the outcome of patients with bulimia nervosa and symptomatic breast hypertrophy (macromastia) who had reduction mammaplasty and to identify factors that were associated with positive outcomes. DESIGN: Case series with semistructured, retrospective, personal interviews performed an average of 4 years after the procedure. SETTING: University hospital-based adolescent eating disorder program. PATIENTS: Five adolescent and young adult females who had been treated for bulimia nervosa and underwent reduction mammaplasty. OUTCOME MEASURES: Presurgical and postsurgical report of physical symptoms, body image and weight control habits, ability to exercise, psychosocial functioning and self-esteem. RESULTS: All patients experienced improvement in physical symptoms (pain and inframammary dermatitis), in their posture, and in their ability to find clothes that fit properly, to exercise, and to avoid embarrassment in social situations. Preoperative eating disorder habits were a dysfunctional attempt to achieve more "normal" body proportions; postoperatively, symptoms of an eating disorder were completely eliminated or greatly reduced. Factors related to favorable outcome included professional validation of patient's symptoms, realistic patient expectations from the surgical procedure, supportive family dynamics, and ongoing treatment for the eating disorder. CONCLUSION: This series of patients with bulimia nervosa and macromastia experienced significant improvement in symptoms related to their eating disorder and their breast hypertrophy following reduction mammaplasty.