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It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry BA in the future. Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4. In comparison, the mean volume of the left breast In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion. Scoliosis is a 3-dimensional torsional deformity of the spine [ 14 , 15 , 17 , 27 ], and is frequently seen with unilateral protrusion f the ribs on our back especially in the scoliosis of the thoracic region [ 7 , 18 , 26 ]. Both in historical and modern-day treatments, correction of the clinical scoliotic deformity in early-onset scoliosis EOS has been the main focus of posterior intervention, in deformity correction during spinal fusion after treatment with growing rod for EOS. The thoracic curve is successfully treated with final fusion performed with posterior pedicle screw instrumentation following the treatment of EOS with growing rod. Previously, the spine surgeons had concentrated only on the posterior deformity, rather than the deformity of the anterior chest wall [ 1 , 2 , 5 , 33 , 35 ].
Aetna considers breast reduction surgery cosmetic unless breast hypertrophy is causing significant pain, paresthesias, or ulceration see selection criteria below. Reduction mammoplasty also spelled as 'mammaplasty' for asymptomatic members is considered cosmetic. Aetna considers breast reduction surgery medically necessary for non-cosmetic indications for women aged 18 or older or for whom growth is complete i. Member has persistent symptoms in at least 2 of the anatomical body areas below, directly attributed to macromastia and affecting daily activities for at least 1 year:. Women 50 years of age or older are required to have a mammogram that was negative for cancer performed within the two years prior to the date of the planned reduction mammoplasty; and. The surgeon estimates that at least the following amounts in grams of breast tissue, not fatty tissue, will be removed from each breast, based on the member's body surface area BSA calculated using the Mosteller formula:. Note : Breast reduction surgery will be considered medically necessary for women meeting the symptomatic criteria specified above, regardless of BSA, with more than 1 kg of breast tissue to be removed per breast. The condition not only must be unresponsive to dermatological treatments e.