Impact of Age, Body Mass Index, and Resection Weight on Postoperative Complications in Reduction Mammaplasty

Abstract

Background: The authors seek to evaluate the impact of age, body mass index (BMI), and resection weight, on postoperative complications in women undergoing primary bilateral reduction mammaplasty. Methods: A retrospective review of all primary bilateral reduction mammaplasties between February of 2014 and August of 2018 was performed. Patient demographics, medical comorbidities, tobacco use, BMI, operative technique, operative time, resection weight, and complications were reviewed. Results: Two hundred seventy-seven women were included. Mean age was 35.71 years, and BMI was 30.17 kg/m2. An inferior pedicle (53.07%) with Wise pattern resection (53.43%) was used most commonly. The minor complication rate was 49.1%, with superficial wounds (42.1%) occurring most commonly. Thirty-three women (11.9%) required greater than 2 months to heal. The major complication rate was 4.31%. BMI was not associated with minor or major complications on univariate analysis (P = 0.1003 and P = 0.6163), but was associated with wound healing requiring greater than 2 months (P = 0.0009), longer operative times (P = 0.0002), and higher resection weights (P < 0.00001). Greater age was associated with higher minor complication rates (P = 0.0048). On multivariate analysis, BMI was associated with wound healing requiring greater than 2 months (P = 0.0137), and age with minor complications (P = 0.0180). No factors impacted major complication rates. Conclusions: Women with higher BMI are more likely to require larger resections, longer operative times, and are at higher risk for wound healing requiring greater than 2 months. Although BMI is an important consideration for determining operative candidacy, the benefits of reduction may outweigh these risks in carefully selected patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.