Does Reduction Mammaplasty for Treatment of Macromastia Play a Role in the Functionality and Performance of Female Athletes?

Abstract

Women’s sports are on the rise, with an increase in enthusiasts, viewers, and, most importantly, participants. Female athletics has made remarkable strides, gaining traction with media coverage and with professional sports associations implementing increased salaries to their athletes. With the women’s sports world ascending, the number of female athletes finding a passion in sport is swiftly growing. From 2017 to 2018, a total of 216,378 female athletes competed in the National Collegiate Athletic Association (NCAA), making up 44 percent of the student-athlete body nationwide. Women’s teams tallied 54 percent of NCAA teams in the country 1. However, with an increase in female participants in athletics, this indubitably opens the discussion of macromastia and its consequences within this population. Macromastia is an issue for many women and is associated with a variety of complaints, such as musculoskeletal pain,2 as well as psychosocial effects, including depression and decreased self-esteem.3 Macromastia and its effects are well known to female athletes. This may subsequently discourage women from participating in sports. For those who decide to pursue sports regardless of their symptomatology due to macromastia, important questions arise. Do female athletes with macromastia experience a reduction in functionality and performance compared with female athletes without macromastia? If so, what role can reduction mammoplasty play in this population? Reduction mammaplasty has been shown to ameliorate symptoms related to macromastia.2,4 Studies have evaluated the relief of symptoms in macromastia patients following reduction mammaplasty. Many studies report improvement in discomfort and pain postoperatively.2 One study focused on pulmonary function before and after reduction mammaplasty. Maximum voluntary ventilation, peak expiratory flow rate, and inspiratory capacity were significantly improved postoperatively. In addition, per analysis of preoperative and postoperative patient questionnaires, subjective findings, such as shortness of breath, were noted to improve.4 With this, it is important to evaluate whether reduction mammaplasty in female athletes would result in improved objective performance within distinct sports. Specific training tests could be administered before and after reduction mammaplasty, such as sprint, jump, agility, and endurance tests, to assess for statistically significant differences in the functionality and performance of the athlete. Macromastia can affect an athlete at any level of sport; however, it is worth noting its effects on elite-level female athletes. A 2018 study reported that elite-level female athletes encounter contact breast injuries appreciably more often in those athletes with larger breasts or greater body mass index, as well as in contact sports. It found that 21 percent of participants who sustained an injury to the breast perceived that it had a negative impact on their athletic performance. Many of these athletes reported altering their physical movements to avoid breast injury, subsequently limiting their physical activity during performance.5 In summary, macromastia is an issue for many women and reduction mammaplasty has proven benefits.2,4 Female athletes are a group that deserves further research to assess whether reduction mammaplasty for treatment of macromastia plays a role in functionality and performance in athletics. If studies were to support this hypothesis, we could see a significant change in the landscape of women’s sports and competition. DISCLOSURE The authors have no financial interest or conflicts of interest to declare in relation to the content of this article. ACKNOWLEDGMENTS This study was supported in part by the Mayo Clinic Center for Individualized Medicine and the Plastic Surgery Foundation.