Breast surgery can be safe with good outcomes for hEDS patients

Benefits of surgery likely outweigh risks to help ease painful symptoms: Report

Margarida Maia, PhD avatar

by Margarida Maia, PhD |

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The idea that plastic surgery is risky for people with hypermobile Ehlers-Danlos syndrome (hEDS) is being challenged in a report of four women with the disorder who underwent successful breast lifting or reduction without added complications.

“A diagnosis of hEDS is not a contraindication to surgery and acceptable outcomes can be achieved,” researchers wrote in an article,“Breast surgery in patients with hypermobile Ehlers-Danlos syndrome,” which was published in the Journal of Plastic, Reconstructive & Aesthetic Surgery.

People with hEDS have hypermobile joints, or joints that move past the normal range of motion, causing frequent dislocations and long-lasting pain. Their skin can be stretchy, and they tend to bruise and bleed easily.

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People with hypermobile EDS often experience pain from large breasts

Patients with hEDS often have aggravated symptoms of macromastia, or enlarged breasts. Although patients with mild hEDS potentially benefit more from surgery than people without the disease, “surgeons are often reluctant to operate on patients with hEDS due to potential wound healing complications, tissue laxity [loose tissue], or bleeding,” the researchers wrote. “However, the benefits of surgery likely outweigh the risks.”

Their report described four women with hEDS who underwent plastic surgery for breast ptosis (sagging breasts) or macromastia. The women were 18 to 42 years old, and they were followed for at least three months after surgery.

One woman, 22, underwent bilateral mastopexy, or lifting of both breasts. Despite a spitting suture, a common complication of skin or plastic surgery when the body rejects an absorbable suture out of the wound, she was satisfied with the outcome of her surgery.

Three women underwent bilateral reduction mammaplasty, or reduction of both breasts. The amount of breast tissue removed ranged from 375 to 1,011 grams (about 0.8 to 2.2 pounds). No complications were reported.

All patients experienced improvement, if not resolution, of neck, back, and shoulder pain.

hEDS patients satisfied with their breast surgery outcomes

“Despite having hEDS, the patients in this study did not experience wound-healing complications or poor scarring and were satisfied with the outcomes of their surgeries,” the researchers wrote.

In women with macromastia, the weight of the breasts can put a strain on the neck, shoulders, and back, causing discomfort and pain. All three women who underwent breast reduction were satisfied with the outcomes of their surgery and experienced pain relief.

“All patients experienced improvement, if not resolution, of neck, back, and shoulder pain, which continued through the postoperative period of at least three months,” the researchers wrote.

While the number of cases is small, the report “highlights the fact that patients with an hEDS diagnosis and/or mild manifestations of the disease can successfully undergo surgery,” the researchers concluded.