A Reliable Method for the Preoperative Estimation of Tissue to Be Removed during Reduction Mammaplasty

Abstract

Insurance requirements for prior authorization of reduction mammaplasty are becoming increasingly stringent, with the sole criterion determined by the surgeon being the estimation of the amount of tissue to be removed. Previous formulas for predicting resected tissue weights have been inconsistent and particularly unreliable in smaller reductions. This study describes a dependable, surgeon-specific method based on two simple preoperative measurements to estimate tissue resection weights in patients undergoing reduction mammaplasty. The medical charts of 72 consecutive patients who underwent reduction mammaplasty were reviewed. Preoperatively obtained measurements from the first 15 patients in the authors' series were plotted against the actual corresponding amount of breast tissue removed at the time of surgery. Linear regression of this plot was used to generate a mathematical formula that was then used to predict resection weights of the subsequent 57 patients. The results were compared with the actual weights recorded intraoperatively. Several measurements were evaluated and Pearson coefficients generated. The mathematical product of two unique breast-only surface measurements along horizontal and vertical planes generated the linear regression formula with the greatest accuracy (r = 0.95) for predicting the weight of tissue to be resected compared with either measurement alone or sternal notch-to-nipple distance. By using two simple preoperative measurements correlated with tissue resection weights in a small series of procedures, any reconstructive surgeon can create his or her own reliable formula for predicting breast tissue resection weights for reduction mammaplasty.