Reply: Does Reduction Mammaplasty for Treatment of Macromast… : Plastic and Reconstructive Surgery

We have read with great interest the comment by Reynolds, Horen, and Hamidian Jahromi to our Viewpoint article.1 We share their sentiment that reduction mammaplasty is an invasive operation that carries with it its own set of risks and benefits.2 It is a decision that a female athlete must make with thorough consideration of a multitude of factors, including physical, psychosocial, and financial. Reynolds et al. describe less invasive alternatives that can be pursued before reduction mammaplasty, such as unique sports bra options that are specific to many different breast shapes and sizes. Even more important, they mention the significance of providing these young, budding female athletes with the knowledge of these resources in order to encourage these young women to continue to pursue their athletic endeavors.3,4

In their comment, they also discuss the psychological component of sports as it relates both to the athlete and to their fans. We strongly agree with their comments with regard to creating an athletic atmosphere that incorporates female athletes of all body, and breast, sizes. However, as we stated in our Viewpoint, macromastia can affect an athlete at any level of sport, and studies report that elite 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.5

Therefore, we support our beliefs that macromastia is an issue for many women and reduction mammaplasty has proven benefits.6,7 Reduction mammaplasty is an invasive operation, and it is vital that the individual athlete contemplate the definitiveness of the procedure preoperatively. In addition, we concur again with Reynolds et al. that the individual female athlete should consider less invasive alternatives initially, but ultimately may require more definitive means, such as reduction mammaplasty. As stated in our article, female athletes deserve further research to assess whether reduction mammaplasty for treatment of macromastia plays a role in functionality and performance in sports. The findings of these studies can have a significant impact in the arena of female athletics.


This study was supported in part by the Plastic Surgery Foundation and by the Mayo Clinic Center for Individualized Medicine.


The authors have no financial interests or conflicts of interest to report.

Jamie L. Kaplan, M.D.
Antonio J. Forte, M.D., Ph.D.
Division of Plastic Surgery
Mayo Clinic
Jacksonville, Fla.


1. Kaplan J, Forte AJ. Does reduction mammaplasty for treatment of macromastia play a role in the functionality and performance of female athletes? Plast Reconstr Surg. 2021;147:1084e.

2. Davis GM, Ringler SL, Short K, Sherrick D, Bengtson BP. Reduction mammaplasty: Long-term efficacy, morbidity, and patient satisfaction. Plast Reconstr Surg. 1995;96:1106–1110.

3. Nolte K, Burgoyne S, Nolte H, van der Meulen J, Fletcher L. The effectiveness of a range of sports bras in reducing breast displacement during treadmill running and two-step star jumping. J Sports Med Phys Fitness 2016;56:1311–1317.

4. Scurr J, Brown N, Smith J, Brasher A, Risius D, Marczyk A. The influence of the breast on sport and exercise participation in school girls in the United Kingdom. J Adolesc Health. 2016;58:167–173.

5. Brisbine BR, Steele JR, Phillips EJ, McGhee DE. The occurrence, causes and perceived performance effects of breast injuries in elite female athletes. J Sports Sci Med. 2019;18:569–576.

6. Gonzalez F, Walton RL, Shafer B, Matory WE Jr, Borah GL. Reduction mammaplasty improves symptoms of macromastia. Plast Reconstr Surg. 1993;91:1270–1276.

7. Iwuagwu OC. Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia. Plast Reconstr Surg. 2003;112:1969–1970; author reply 1970.


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