Kreipe R E, Lewand A G, Dukarm C P, Caldwell E H
Strong Children's Research Center, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, NY, USA.
Arch Pediatr Adolesc Med. 1997 Feb;151(2):176-80. doi: 10.1001/archpedi.1997.02170390066012.
To determine the outcome of patients with bulimia nervosa and symptomatic breast hypertrophy (macromastia) who had reduction mammaplasty and to identify factors that were associated with positive outcomes.
Case series with semistructured, retrospective, personal interviews performed an average of 4 years after the procedure.
University hospital-based adolescent eating disorder program.
Five adolescent and young adult females who had been treated for bulimia nervosa and underwent reduction mammaplasty.
Presurgical and postsurgical report of physical symptoms, body image and weight control habits, ability to exercise, psychosocial functioning and self-esteem.
All patients experienced improvement in physical symptoms (pain and inframammary dermatitis), in their posture, and in their ability to find clothes that fit properly, to exercise, and to avoid embarrassment in social situations. Preoperative eating disorder habits were a dysfunctional attempt to achieve more "normal" body proportions; postoperatively, symptoms of an eating disorder were completely eliminated or greatly reduced. Factors related to favorable outcome included professional validation of patient's symptoms, realistic patient expectations from the surgical procedure, supportive family dynamics, and ongoing treatment for the eating disorder.
This series of patients with bulimia nervosa and macromastia experienced significant improvement in symptoms related to their eating disorder and their breast hypertrophy following reduction mammaplasty.
确定神经性贪食症合并有症状性乳腺肥大（巨乳症）且接受了乳房缩小整形术的患者的治疗结果，并找出与积极结果相关的因素。
病例系列研究，在手术后平均4年进行半结构化、回顾性的个人访谈。
大学医院的青少年饮食失调项目。
五名接受过神经性贪食症治疗并接受了乳房缩小整形术的青少年和年轻成年女性。
术前和术后关于身体症状、身体意象和体重控制习惯、运动能力、心理社会功能和自尊的报告。
所有患者在身体症状（疼痛和乳房下皮炎）、姿势、找到合身衣服的能力、运动能力以及避免在社交场合尴尬等方面均有改善。术前的饮食失调习惯是试图实现更“正常”身体比例的一种功能失调的尝试；术后，饮食失调症状完全消除或大幅减轻。与良好结果相关的因素包括对患者症状的专业确认、患者对手术的现实期望、支持性的家庭动态以及对饮食失调的持续治疗。
这一系列神经性贪食症合并巨乳症的患者在接受乳房缩小整形术后，与饮食失调和乳腺肥大相关的症状有显著改善。
