The effects of breast reduction on pulmonary functions: A systematic review

Published:August 28, 2022DOI:


      Breast reduction is one of the most commonly requested and performed plastic surgery procedures, and its psychological, esthetic, and analgesic benefits are well known. Several studies dealing with the effects of reduction mammoplasty on the physiology of respiration have been published in the past decades. This systematic review aims to assess whether bilateral breast reduction is associated with measurable improvement in lung function in women with macromastia. This review was performed in accordance with the PRISMA guidelines. PubMed, SCOPUS, and Web of Science databases were queried in search of clinical studies that investigated lung function in women undergoing breast reduction for macromastia and reported any type of parameter or outcome measure relevant to pulmonary function. The search yielded 394 articles of which 15 articles met our specific inclusion criteria. The primary outcome measures of the studies and their respective results were tabulated, contrasted, and compared. The 15 studies included in this review cover the period from 1974 to 2018. According to most included studies, reduction mammaplasty produces a change of objective respiratory parameters, such as spirometric tests or arterial blood gas (ABG) measurements; nevertheless, the clinical and functional relevance of the observed changes is debatable.


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      1. American Society for Aesthetic Plastic Surgery (2019) ASAPS aesthetic plastic surgery national databank (

        • Lonie S.
        • Sachs R.
        • Shen A.
        • Hunter-Smith D.J.
        • Rozen W.M.
        • Seifman M.
        A systematic review of patient reported outcome measures for women with macromastia who have undergone breast reduction surgery.
        Gland Surg. 2019; 8: 431-440
        • Conway H.
        Weight of the breasts as a handicap to respiration. An argument for reduction mammaplasty in selected cases.
        Am J Surg. 1962; 103: 674-676
        • Turhan-Haktanir N.
        • Fidan F.
        • Köken G.
        • et al.
        Effects of breast size on lung function.
        Eur J General Med. 2010; 7: 150-154
      2. Oxford Centre for Evidence-Based Medicine.

      3. Joanna Briggs Institute critical appraisal tools.

        • Iwuagwu O.C.
        • Platt A.J.
        • Stanley P.W.
        • Hart N.B.
        • Drew P.J.
        Does reduction mammaplasty improve lung function test in women with macromastia? Results of a randomized controlled trial.
        Plast Reconstr Surg. Jul 2006; 118 (discussion 7): 1-6
        • Kececi Y.
        • Dagistan S.
        Effects of breast reduction on pulmonary function.
        Int Surg. Jul-Aug 2014; 99: 300-304
        • Nafae R.
        • Mohamed N.A.
        • Amany F.M.
        • et al.
        The effect of weight reduction versus reduction mammoplasty on the pulmonary function parameters and leptin level in obese-macromazia subjects.
        Egyptian J Chest Dis Tuberculosis. 2013; 62: 723-729
        • Starley I.F.
        • Bryden D.C.
        • Tagari S.
        • Mohammed P.
        • Jones B.P.
        An investigation into changes in lung function and the subjective medical benefits from breast reduction surgery.
        Br J Plast Surg. Oct 1998; 51: 531-534
        • Sood R.
        • Mount D.L.
        • Coleman 3rd, J.J.
        • et al.
        Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia.
        Plast Reconstr Surg. Feb 2003; 111: 688-694
        • Cunha M.S.
        • Santos L.L.
        • Viana A.A.
        • Bandeira N.G.
        • Filho J.A.
        • Meneses J.V.
        Evaluation of pulmonary function in patients submitted to reduction mammaplasty.
        Rev Col Bras Cir. Jan-Feb 2011; 38: 11-14
        • Ceber M.
        • Yuksek A.
        • Mutlu L.C.
        • Bali I.
        • Topcu B.
        Reduction mammaplasty effect on pulmonary function and arterial blood gas in the overweight female.
        Aesthetic Plast Surg. Aug 2015; 39: 540-546
        • Uğurlu E.
        • Topkara A.
        • Özkan A.
        • Özcan R.H.
        • Can İ.
        • Altınışık G.
        Effect of reduction mammoplasty on the pulmonary function tests.
        Tuberk Toraks. Jun 2017; 65: 112-116
        • Izadpanah A.
        • Karunanayake M.
        • Bracco D.
        • Luc M.
        Effect of reduction mammoplasty on chest wall compliance.
        Eur J Plast Surg. 2012; 35: 845-846
        • Goldwyn R.M.
        Pulmonary function and bilateral reduction mammaplasty.
        Plast Reconstr Surg. Jan 1974; 53: 84
        • Elhusseiny A.
        • Elshahat A.
        • Wagih K.
        • Hanafy A.A.
        • Mahmoud A.S.
        Relation between reduction mammaplasty and pulmonary functions.
        Ann Plast Surg. Mar 2013; 70: 271-275
        • Onuk A.A.
        • Senen D.
        • Arslan B.
        • Muslu U.
        • Tek M.
        • Karslı B.
        Effects of bilateral breast reduction on peak airway pressure and pulmonary function tests.
        Niger J Clin Pract. Aug 2018; 21: 949-953
        • Camp D.F.
        • Dickson M.G.
        • Dormon F.
        Perioperative improvement in lung function during reduction mammoplasty.
        Br J Plast Surg. 1999; 52: 238-239
        • Wiser I.
        • Mahon K.
        • Yaniv S.
        • Ziv E.
        • Carmel N.N.
        • Heller L.
        Intraoperative pulmonary function dynamics in adolescents undergoing reduction mammoplasty: a prospective case series.
        Plast Surg (Oakv). 2015; 23 (Winter): 244-246
        • Fiumara L.
        • Gault D.T.
        • Nel M.R.
        • Lucas D.N.
        • Courtauld E.
        Massive bilateral breast reduction in an 11-year-old girl: 24% ablation of body weight.
        J Plast Reconstr Aesthet Surg. Aug 2009; 62: e263-e266
        • Papanastasiou C.
        • Ouellet J.A.
        • Lessard L
        The effects of breast reduction on back pain and spine measurements: a systematic review.
        Plast Reconstr Surg Glob Open. 12 Aug 2019; 7: e2324
        • Mian S.
        • Dyson E.
        • Ulbricht C.
        Reduction mammoplasty and back pain: a systematic review and meta-analysis.
        Eur Spine J. Mar 2020; 29: 497-502
        • Moscariello A.
        • Zielonka E.
        • Gris P.
        • Molle J.-.P.
        Reduction mammaplasty and functional respiratory repercussion.
        Chest. October 1996; 110: SUPPL.60S
        • Kemler M.A.
        • Lapid O.
        • Strackee S.D.
        Does reduction mammaplasty improve lung function test in women with macromastia?.
        Plast Reconstr Surg. Jul 2007; 120 (author reply 351-2): 350-351
        • Donohue J.F.
        Minimal clinically important differences in COPD lung function.
        COPD. Mar 2005; 2: 111-124
        • Jones P.W.
        • Beeh K.M.
        • Chapman K.R.
        • Decramer M.
        • Mahler D.A.
        • Wedzicha J.A.
        Minimal clinically important differences in pharmacological trials.
        Am J Respir Crit Care Med. 1 Feb 2014; 189: 250-255
        • du Bois R.M.
        • Weycker D.
        • Albera C.
        • et al.
        Forced vital capacity in patients with idiopathic pulmonary fibrosis: test properties and minimal clinically important difference.
        Am J Respir Crit Care Med. 15 Dec 2011; 184: 1382-1389
        • Hegewald M.J.
        Impact of obesity on pulmonary function: current understanding and knowledge gaps.
        Curr Opin Pulm Med. 1 Mar 2021; 27: 132-140
        • Dixon A.E.
        • Peters U.
        The effect of obesity on lung function.
        Expert Rev Respir Med. Sep 2018; 12: 755-767
        • Bayramiçli M.
        • Sirinoglu H.
        • Yalçin D.
        Outcome after breast reduction considering body mass index and resection amount.
        Aesthet Surg J. 16 Oct 2017; 37: 1103-1110