Breast Surgery Outcomes in Patients with Hypermobile Ehlers-Danlos Syndrome (hEDS)

Breast Surgery Outcomes in Patients with Hypermobile Ehlers-Danlos Syndrome (hEDS)

Breast surgery, particularly in individuals with hypermobile Ehlers-Danlos syndrome (hEDS), is a subject that has long sparked debate within the medical community. Concerns have often centered around the potential complications associated with wound healing, scarring, and overall patient outcomes, given the underlying connective tissue disorder present in hEDS. However, recent findings published in the Journal of Plastic, Reconstructive & Aesthetic Surgery provide encouraging evidence that breast surgery can be safely and effectively performed in this patient population, yielding satisfactory results.

Understanding hEDS and Its Challenges in Surgery

Hypermobile Ehlers-Danlos syndrome (hEDS) is the most common subtype of Ehlers-Danlos syndrome, a group of genetic disorders that affect collagen production and structure. Patients with hEDS typically exhibit hypermobile joints, skin that may be excessively stretchy, and a tendency to bruise easily. These characteristics have historically made surgeons wary of performing elective procedures, such as breast surgery, due to the heightened risk of complications like poor wound healing and extensive scarring.

Despite these concerns, the study highlights that for patients with hEDS suffering from conditions such as macromastia (overly large breasts) or breast ptosis (sagging breasts), the benefits of surgery may outweigh the risks. Breast hypertrophy can exacerbate the symptoms of hEDS, leading to physical discomfort and psychosocial distress. Therefore, surgical intervention can provide significant relief and improve quality of life for these patients.

Study Findings: A Reassurance for Patients and Surgeons

The study, conducted between June 2011 and July 2021, involved a retrospective review of four female patients with hEDS who underwent breast surgery at two institutions. The surgeries included bilateral mastopexy (breast lift) and bilateral reduction mammaplasty (breast reduction), procedures often sought by patients dealing with the physical and emotional burdens of macromastia or ptosis.

The outcomes of the study were promising. Despite the potential complications associated with hEDS, none of the patients experienced significant postoperative issues such as wound dehiscence (wound reopening) or poor scarring, which are common concerns in this population. Additionally, all patients reported satisfaction with their surgical outcomes, particularly in terms of pain relief. The reduction in breast size alleviated neck, back, and shoulder pain, significantly improving their physical comfort and overall well-being.

Implications for Surgical Practice

These findings challenge the traditional reluctance to perform elective surgeries on patients with hEDS. The successful outcomes in this case series suggest that with careful surgical planning and patient management, individuals with hEDS can undergo breast surgery without an increased risk of complications. This not only opens doors for those suffering from the physical ailments associated with large breasts but also enhances their body image and quality of life.

The study’s authors emphasize that a diagnosis of hEDS should not be viewed as a contraindication to breast surgery. Instead, with proper care, these patients can achieve outcomes comparable to those of the general population. The study underscores the importance of individualized treatment plans that take into account the unique characteristics of hEDS while still allowing patients to benefit from surgical interventions that can significantly improve their quality of life.

Conclusion

The recent research on breast surgery outcomes in patients with hypermobile Ehlers-Danlos syndrome offers a reassuring perspective for both patients and healthcare providers. The evidence suggests that with meticulous surgical technique and postoperative care, patients with hEDS can undergo breast surgery with positive outcomes, dispelling long-held concerns about heightened risks. As this understanding grows, it is likely that more patients with hEDS will have access to the surgical treatments they need, leading to better management of the physical and psychosocial challenges associated with their condition.

‍

References:

1. Morris, B. E., Ishimoto, A. K., Casey, W. J. III, Rebecca, A. M., & Kurnik, N. M. (2024). Breast surgery in patients with hypermobile Ehlers-Danlos syndrome. Journal of Plastic, Reconstructive & Aesthetic Surgery, 88, 109-111. https://doi.org/10.1016/j.bjps.2023.10.120
2. Surgery in EDS: Risks, Considerations, and Recovery. (n.d.). The Ehlers-Danlos Clinic. Retrieved from https://www.eds.clinic/articles/surgery-in-eds-risks-considerations-recovery

‍

‍