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My grand daughter is 12 years old and a bit overweight. Presently she is wearing a...

Q:

My grand daughter is 12 years old and a bit overweight. Presently she is wearing a size 42DDD bra. She complains of having neck pain and lower shoulder pain. The size of her breasts are truly affecting her outlook on life and her personality and causing her to be depressed. I don't think she should have to go through this and wait until she has reached an adult age to have a breast reduction. With parental consent, wouldn’t she be eligible to have the surgery now?

A:

Breast reduction surgery can be a life changing operation. The complaints that your granddaughter has are common for women with large breasts. Pain occurs primarily in the lower neck, upper back and shoulders, but the breasts themselves can also be painful. Constant skin to skin contact beneath the breast can result in a recurrent rash that can be difficult to treat. The benefit of breast reduction surgery is that these types of problems usually improve, and in many cases completely resolve. While the benefits may seem obvious, the risks also need to be discussed in detail with the Board Certified Plastic Surgeon you choose. Here are a few things to consider:

Development of the breast is not complete at age 12. It is best that the breasts are stable in size prior to reduction surgery. There is an increased risk that the procedure will need to be repeated in the future when breast reduction surgery is performed at a young age. In other words, if the breast is still growing, it will likely continue to grow after surgery.

Psychological development in a patient is not complete at age 12. Maturity occurs gradually and faster in some than others. It would be important for the plastic surgeon to evaluate your granddaughter's maturity to see if she is ready to make the decision. This can help not only to determine if she is equipped to handle the surgery and subsequent recovery, but also to minimize the risk of this being a surgery that she regrets in the future.

There is scarring as a result of breast reduction surgery, and this is the big tradeoff. Most patients are very happy to trade in their back and neck pain for scars that are covered by clothing. Moreover, clothing tends to fit better after the surgery. It may be easier for patients who are married and already have had children. Most are in a stable, supportive relationship. They have had a chance to discuss the surgery with their mate prior to having the operation, and they do not have to worry about dating someone new and explaining the scars.

Breast feeding will likely be affected. The most common types of breast reduction surgeries maintain the connection between the nipple and a portion of the remaining breast tissue. This may allow for breast feeding in the future, but breast reduction patients need to accept the fact that breast feeding may not be possible after surgery. Since a significant percentage of the breast is removed, a much smaller amount of breast tissue remains to produce milk.

Other considerations are needed, and additional information is available on the ASAPS web site at www.surgery.org. I have tried to focus in on the unique issues that pertain to breast reduction surgery at an early age. It is not possible to be precise via e-mail. If your granddaughter is seriously considering breast reduction surgery, she will need to make a consultation appointment with a Board Certified Plastic Surgeon. After a brief history and physical examination, the surgeon can provide you with specific information.

It would be important that family be involved, and should attend all doctor’s visits, especially the consultation appointments. You may want to give your granddaughter some privacy during the brief physical examination, but she will probably find it reassuring to have supportive family members around. This can help her ask pertinent questions, and remember the answers. All will get a chance to ask questions and get comfortable with the idea prior to proceeding - this can only help make the experience a good one. Whether the decision is made to proceed or wait, you will have all the information you need to make an informed decision.

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