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. 2022 Oct 1;150(4):731-738.
doi: 10.1097/PRS.0000000000009513. Epub 2022 Jul 22.

The Impact of Combined Oral Contraceptives on Adolescents with Macromastia

Laura C Nuzzi  1 , Tannishtha Pramanick  1 , Gabrielle G Massey  1 , Landis R Walsh  1 , Catherine T McNamara  1 , Joseph M Firriolo  1 , Amy D DiVasta  1 , Brian I Labow  1
Affiliations

The Impact of Combined Oral Contraceptives on Adolescents with Macromastia

Laura C Nuzzi et al. Plast Reconstr Surg. .

Abstract

Background: The combined oral contraceptive pill, containing both estrogen and progestin, is commonly prescribed to adolescents for numerous health benefits. However, there is concern among patients and providers that its use may exacerbate breast growth. This retrospective, case-control study examined the association between combined oral contraceptive pill use and macromastia-related breast hypertrophy and symptoms in adolescents.

Methods: A total of 378 patients undergoing reduction mammaplasty between the ages of 12 and 21 years were assessed for baseline and postoperative breast symptoms and combined oral contraceptive pill use. In addition, the medical records of 378 female controls of the same age range were retrospectively reviewed.

Results: Although a lower proportion of the macromastia cohort used any hormonal contraception compared to controls (37.8 percent versus 64.8 percent; OR, 0.33; 95 percent CI, 0.24 to 0.44; p < 0.001), they were more often prescribed combined oral contraceptive pills (82.5 percent versus 52.7 percent; OR, 1.93; 95 percent CI, 1.29 to 2.68; p < 0.001). Participants with macromastia who used combined oral contraceptive pills had a smaller median normalized amount of breast tissue resected during reduction mammaplasty than those who never used hormonal contraception (639.5 g/m 2 versus 735.9 g/m 2 ; p = 0.003). Combined oral contraceptive pills were not associated with breast-related symptoms or clinical impairment, or postoperative breast growth ( p > 0.05 for all).

Conclusions: Combined oral contraceptive pill use during adolescence may be associated with developing less severe breast hypertrophy. Combined oral contraceptive pills do not appear to exacerbate macromastia-related symptoms or impact postoperative growth in young women following reduction mammaplasty. Although additional research is needed, providers are encouraged to consider combined oral contraceptive pills for their patients with macromastia when indicated and appropriate.

Clinical question/level of evidence: Risk, III.

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References

    1. Cerrato F, Webb ML, Rosen H, et al. The impact of macromastia on adolescents: A cross-sectional study. Pediatrics 2012;130:e339–e346.
    1. Singh KA, Losken A. Additional benefits of reduction mammaplasty: A systematic review of the literature. Plast Reconstr Surg. 2012;129:562–570.
    1. Mello AA, Domingos NA, Miyazaki MC. Improvement in quality of life and self-esteem after breast reduction surgery. Aesthetic Plast Surg. 2010;34:59–64.
    1. Thoma A, Sprague S, Veltri K, Duku E, Furlong W. A prospective study of patients undergoing breast reduction surgery: Health-related quality of life and clinical outcomes. Plast Reconstr Surg. 2007;120:13–26.
    1. Evans GR, Ryan JJ. Reduction mammaplasty for the teenage patient: A critical analysis. Aesthetic Plast Surg. 1994;18:291–297.

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