Disparities in Access and Outcomes of Bilateral Reduction Mammaplasty (BRM): A Systematic Review.

Abstract

Bilateral reduction mammaplasty is a common surgical procedure aimed at alleviating the physical and psychological burdens of macromastia. However, disparities in access and outcomes persist, influenced by racial, socioeconomic, and geographic factors. This systematic review synthesizes current literature on these disparities to inform future research and policy. We conducted a comprehensive search of PubMed, Embase, and Scopus databases for studies published up to June 2024. Inclusion criteria focused on peer-reviewed studies addressing disparities in bilateral reduction mammaplasty. Data were extracted regarding study design, population, and key findings, with an emphasis on racial, socioeconomic, and geographic disparities. A total of 11 studies, encompassing 24,812 patients, were included. Findings indicate significant racial disparities, with Black and Hispanic patients more likely to undergo surgery yet facing greater barriers and complications. Socioeconomic factors revealed that higher income and private insurance correlate with increased access, whereas Medicaid patients encountered higher denial rates. Geographic disparities highlighted variations in access based on local funding criteria and healthcare infrastructure. Despite these challenges, all studies reported significant improvements in quality of life post-surgery. This review underscores the multifaceted nature of disparities in bilateral reduction mammaplasty. Addressing these inequities requires targeted interventions and policy reforms to improve access and outcomes for all patients, ensuring equitable healthcare delivery.