OUTCOME FOR PATIENTS WITH BULIMIA AND BREAST HYPERTROPHY AFTER REDUCTION MAMMAPLASTY

Objectives: To determine the outcome of patients with bulimia nervosa and symptomatic breast hypertrophy (macromastia) who had reduction mam maplasty and to identify factors that were associated with positive ou tcomes. Design: Case series with semistructured, retrospective, person al interviews performed an average of 4 years after the procedure. Set ting: University hospital-based adolescent eating disorder program. Pa tients: Five adolescent and young adult females who had been treated f or bulimia nervosa and underwent reduction mammaplasty. Outcome Measur es: Presurgical and postsurgical report: of physical symptoms, body im age and weight control habits, ability to exercise, psychosocial funct ioning, and self-esteem. Results: All patients experienced improvement in physical symptoms (pain and inframammary dermatitis), in their pos ture, and in their ability to find clothes that fit properly, to exerc ise, and to avoid embarrassment in social situations. Preoperative eat ing disorder habits were a dysfunctional attempt to achieve more ''nor mal'' body proportions; postoperatively, symptoms of an eating disorde r were completely eliminated or greatly reduced. Factors related to fa vorable outcome included professional validation of patient's symptoms , realistic patient expectations from the surgical procedure, supporti ve family dynamics, and ongoing treatment for the eating disorder. Con clusion: This series of patients with bulimia nervosa and macromastia experienced significant improvement in symptoms related to their eatin g disorder and their breast hypertrophy following reduction mammaplast y.