WORLD JOURNAL OF PLASTIC SURGERY
Thu, Aug 20, 2026
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1- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States & Department of Plastic Surgery, Kaiser Permanente South Bay Medical Center, Gardena, California, United States , Hossein.Masoomi@kp.org
2- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States
2- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States
Abstract: (7 Views)
Background: Breast reduction improves quality of life for patients with breast hypertrophy in any Body Mass Index (BMI) category. We aimed to evaluate how BMI affected postoperative outcomes of breast reduction using a large nationwide database.
Methods: Using the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database, we examined patients undergoing breast reduction for hypertrophy from 2016 to 2020. Patients who had reductions for symmetry, oncoplastic reconstruction, or combined with panniculectomy were excluded.
Results: A total of 23,171 patients met inclusion criteria. Mean age was 40.7 years, and mean BMI was 31.0 +/- 6.8. Most patients (75%) had BMI<35. Mean operative time was 152 +/- 63 minutes. Overall complication rate was 5.0%, increasing from 2.4% in BMI<25 group to 11.4% in BMI>45. Many complications were related to the surgical site complications (4.4%), rising from 2.4% in BMI<25 to 10.2% in BMI>45. Rates of return to the operating room within 30 days (2.0%), venous thromboembolism (0.2%), urinary tract infection (0.2%), pneumonia (0.1%), and myocardial infarction (0.0%) did not differ significantly across BMI groups.
Conclusion: Higher BMI is associated with increased postoperative complications after breast reduction, primarily due to surgical-site events. However, BMI does not appear to affect rates of medical complications or unplanned returns to the operating room. Given the overall low risk and the benefits of surgery, obesity alone should not exclude patients from reduction mammaplasty. Patients should instead receive individualized risk counseling and assessment.
Methods: Using the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database, we examined patients undergoing breast reduction for hypertrophy from 2016 to 2020. Patients who had reductions for symmetry, oncoplastic reconstruction, or combined with panniculectomy were excluded.
Results: A total of 23,171 patients met inclusion criteria. Mean age was 40.7 years, and mean BMI was 31.0 +/- 6.8. Most patients (75%) had BMI<35. Mean operative time was 152 +/- 63 minutes. Overall complication rate was 5.0%, increasing from 2.4% in BMI<25 group to 11.4% in BMI>45. Many complications were related to the surgical site complications (4.4%), rising from 2.4% in BMI<25 to 10.2% in BMI>45. Rates of return to the operating room within 30 days (2.0%), venous thromboembolism (0.2%), urinary tract infection (0.2%), pneumonia (0.1%), and myocardial infarction (0.0%) did not differ significantly across BMI groups.
Conclusion: Higher BMI is associated with increased postoperative complications after breast reduction, primarily due to surgical-site events. However, BMI does not appear to affect rates of medical complications or unplanned returns to the operating room. Given the overall low risk and the benefits of surgery, obesity alone should not exclude patients from reduction mammaplasty. Patients should instead receive individualized risk counseling and assessment.
Type of Study: Original Article |
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