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Breast Reduction in Adults: Identifying Risk Factors for Overall 30-Day Postoperative Complications.

BACKGROUND
Breast reduction is a commonly performed procedure. Understanding postoperative complication profile is important for preoperative planning and patient education.


OBJECTIVE
We sought to assess complication rates following breast reduction in females and identify potential risk factors.


METHODS
We assessed the records of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant use files that include patients who have undergone breast reduction for macromastia between 2005-2016. Relevant patient and postoperative data was extracted and factors affecting complications were analyzed using the logistic regression model.


RESULTS
We identified 20,001 women who underwent breast reduction. Mean age was 43.9 years. The number of patients who developed ≥1 complications was 1,009 (4.3%). Our adjusted analysis revealed that outpatient setting (OR=0.600) and performance of the surgery by the attending alone (OR=0.678) were associated with lower odds, whereas higher body mass index (BMI) (OR=1.046) and smoking (OR=1.518) were associated with higher odds for complications following breast reduction. Outpatient setting (OR=0.317) was also associated with lower odds while smoking (OR=1.613) and ASA class were associated with higher odds of returning to the operative room. These finds were consistent in our subgroup analysis for wound-related complications.


CONCLUSIONS
Our study shows that patient characteristics such as smoking and BMI may increase complication rates after breast reduction. Clinical factors such as inpatient setting may also increase risk of complications following breast reduction. It is critical to understand the effect of these factors to better predict postoperative outcomes and ensure thorough patient education.