Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Society of Plastic Surgeons.

Reduction Mammaplasty

American Society of Plastic Surgeons

Publication Date: Mar 1, 2022

Page Last Updated: May 5, 2026

Grading of Recommendations

ASPS Recommendation Quality
Strength	Description	Benefits OR Harms Predominate	Benefits and Harms Balanced
Strong (High Quality)	Evidence from two or more "high" quality studies with consistent findings for recommending for or against the intervention.	Strong or moderate recommendation	Option
Moderate Quality Evidence	Evidence from two or more "moderate" quality studies with consistent findings, or evidence from a single "high" quality study for recommending for or against the intervention.	Moderate or strong recommendation
Low Quality Evidence	Evidence from one or more "low" quality studies with consistent findings, or evidence from a single "moderate" quality study for recommending for or against the intervention.	Moderate or weak recommendation
Very Low Quality Evidence	Evidence from one or more "very low" quality studies with consistent findings, or evidence from a single "low" quality study for recommending for or against the intervention.	Weak recommendation	No recommendation may be made
ASPS Recommendation Stength
Descriptor	Definition	Implications for Practice
Strong	A particular action is favored because anticipated benefits clearly exceed harms (or vice versa), and quality of evidence is excellent (moderate or strong) or unobtainable.	Clinicians should follow a strong recommendation unless a clear and compelling rationale for an alternative approach is present.
Moderate	A particular action is favored because anticipated benefits clearly exceed harms (or vice versa), and the quality of evidence is good but not excellent (or is unobtainable).	Clinicians would be prudent to follow a moderate recommendation but should remain alert to new information and sensitive to patient preferences.
Weak	A particular action is favored because anticipated benefits clearly exceed harms (or vice versa), but the quality of evidence is low or very low.	Clinicians would be prudent to follow a weak recommendation but should remain alert to new information and very sensitive to patient preferences.
Option	An option is provided when the aggregated data show evidence of both benefit and harm that appear similar in magnitude for any available courses of action.	Clinicians should consider the options in their decision-making, but patient preference may have a substantial role.

Document Overview

Document Title: Reduction Mammaplasty

Authoring Society: American Society of Plastic Surgeons

Document Publication Date: Mar 1, 2022

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journals.lww.com/plasreconsurg/Fulltext/2022/03000/American_Society_of_Plastic_Surgeons.9.aspx

Source Citation: Perdikis G, Dillingham C, Boukovalas S, Ogunleye AA, Casambre F, Dal Cin A, Davidson C, Davies CC, Donnelly KC, Fischer JP, Johnson DJ, Labow BI, Maasarani S, Mullen K, Reiland J, Rohde C, Slezak S, Taylor A, Visvabharathy V, Yoon-Schwartz D. American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty. Plast Reconstr Surg. 2022 Mar 1;149(3):392e-409e. doi: 10.1097/PRS.0000000000008860. PMID: 35006204.

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: A multidisciplinary work group involving stakeholders from various backgrounds and societies convened to revise the guideline for reduction mammaplasty. The goal was to develop evidence-based patient care recommendations using the new American Society of Plastic Surgeons guideline methodology. The work group prioritized reviewing the evidence around the need for surgery as first-line treatment, regardless of resection weight or volume. Other factors evaluated included the need for drains, the need for postoperative oral antibiotics, risk factors that increase complications, a comparison in outcomes between the two most popular techniques (inferior and superomedial), the impact of local anesthetic on narcotic use and other nonnarcotic pain management strategies, the use of epinephrine, and the need for specimen pathology. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development and Evaluation methodology). Evidence-based recommendations were made and strength was determined based on the level of evidence and the assessment of benefits and harms.

Scope: Management

Diseases/Conditions (MeSH)

D016462 - Mammaplasty

Keywords: Breast reduction, Mammaplasty, Reduction mammaplasty

Inclusion Criteria: Female, Adult, Older Adult

Health Care Settings: Ambulatory, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 101

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No