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Evidence-Based Medicine: Reduction Mammaplasty

Kerrigan, Carolyn L. M.D., M.H.C.D.S.; Slezak, Sheri S. M.D.

Plastic and Reconstructive Surgery: December 2013 - Volume 132 - Issue 6 - p 1670–1683
doi: 10.1097/PRS.0b013e3182a807ec
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Learning Objectives: After reading this article, the participant should be able to: 1. Accurately state the indications for breast imaging prior to breast reduction; 2. List the modifiable risk factors in a woman considering breast reduction. 3. Use perioperative antibiotics in an evidence based fashion. 4. Identify factors that are associated with higher rates of perioperative complications. 5. Describe the risks and benefits of breast infiltration with epinephrine. 6. Describe the pros and cons of using drains following breast reduction. 7. Describe the incidence of invasive breast cancer in surgical specimens compared to autopsy specimens. 8. Identify common questionnaires that can be used to track short and long-term outcomes following breast reduction. 9. List at least three current practices that are now evolving and changing based on evidence based medicine.

Summary: This paper is designed to summarize key evidence based steps in the care of women undergoing reduction mammaplasty. In addition, the authors identify gaps between how plastic surgeons practice breast reduction and what the best evidence supports. The article was prepared to accompany practice-based assessment with ongoing surgical education for the Maintenance of Certification Program of the American Board of Plastic Surgery.

Supplemental Digital Content is available in the text.

Lebanon, N.H.; and Baltimore, Md.

From the Geisel School of Medicine at Dartmouth and the Dartmouth Institute for Health Policy and Clinical Practice, Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center; the Department of Surgery, University of Maryland School of Medicine; and the Division of Plastic Surgery, University of Maryland Medical Center.

Received for publication April 30, 2012; accepted June 12, 2012.

Disclosure: Neither of the authors has any financial conflicts of interest to report. There was no funding for this article.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s Web site (

Carolyn L. Kerrigan, M.D., M.Sc., Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, N.H. 03756,

©2013American Society of Plastic Surgeons