A study published in the October issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, found that combined oral contraceptives (COCs) containing both oestrogen and progestin do not contribute to the development of enlarged breasts (macromastia), nor do they increase the risk of breast regrowth in adolescents and young women following breast-reduction surgery (ASPS).
Wolters Kluwer published the journal as part of the Lippincott portfolio.
According to new research by ASPS Member Surgeon Brian I. Labow, MD, of Boston Children's Hospital and Harvard Medical School and colleagues, utilising COCs during adolescence may actually be connected with having less severe breast enlargement (hypertrophy).
Doctors are recommended to investigate COCs for young ladies suffering from macromastia.
Breast reduction surgery, also known as reduction mammaplasty, is an effective treatment for adolescents and women with macromastia that reduces pain and psychosocial issues. The most common type of hormonal contraception is combined oral contraceptives (HCs). COCs are used to treat a variety of diseases in adolescents, including acne, menstrual irregularities, endometriosis, and polycystic ovary syndrome, in addition to their contraceptive benefits.
"Despite the favourable effects of COCs, many patients, parents, and clinicians are concerned that their usage would increase breast hypertrophy in teenagers," write Dr Labow and colleagues. "The internet is littered with anecdotal accounts and lay articles suggesting that COC use in adolescents and young women may result in breast growth," they write. "The internet is littered with anecdotal accounts and lay articles suggesting that COC use in adolescents and young women may result in breast growth."
What is the genuine influence of COCs on breast enlargement and symptoms in young women and girls? The study comprised 378 patients receiving reduction mammaplasty at Boston Children's Hospital, ranging in age from 12 to 21 years. The severity of macromastia was compared among patients who used COCs and other HCs, as well as breast regrowth in the first year after reduction mammaplasty.
The findings were compared to those of 378 female patients of the same age in a control group. In both groups, the average age was around 18 years. Patients who had macromastia were more likely to be overweight or obese, which is consistent with the idea that obesity is a risk factor for macromastia.
Overall, patients with macromastia used fewer HCs: roughly 38% versus 65% in the control group. Women taking HCs with macromastia, on the other hand, were more likely to be prescribed COCs: 83% versus 53%. The dosages of oestrogen and progestin were comparable among groups.
Using COCs did not appear to reduce the severity of breast enlargement in patients with macromastia. The median quantity of breast tissue removed during reduction mammaplasty was similar between groups - in fact, somewhat less in women who used COCs compared to no HC use. Pain and other macromastia symptoms (such as irritation of the breast skin, trouble exercising, or difficulty finding clothes that fit) were also similar between groups.
There was no significant difference in the rate of breast regrowth between patients who used COCs and those who did not use COCs at a median follow-up of around 2 years after reduction mammaplasty. In total, around 5% of individuals experienced postoperative breast regrowth. Approximately half of the cases were caused by breast gland regrowth rather than weight increase. Women who took COCs following reduction mammaplasty likewise had no higher risk of breast regrowth.
According to Dr Labow and colleagues, the data serve to dispel "pervasive anecdotal assertions" that COCs throughout adolescence may raise the incidence of macromastia. "Although more study is needed," they conclude, "providers are urged to consider COCs when prescribing HCs for their patients with macromastia where necessary and suitable." (ANI)