The impact of body mass index on reduction mammaplasty: a multicenter analysis of 2492 patients.
BACKGROUND
Reduction mammaplasty is commonly performed in women who are considered obese by the body mass index (BMI) classification of the World Health Organization.


OBJECTIVE
The authors compare complication rates among breast reduction patients, stratified by BMI, across multiple institutions.


METHODS
A retrospective analysis was performed of all reduction mammaplasties in the database of the National Surgical Quality Improvement Program for 2006 through 2010. Demographic, comorbidity, and BMI data were collected. Data on medical and surgical complications, reoperation, and mortality were collected through 30 days postsurgery.


RESULTS
Of 2492 patients, 55% were considered obese (BMI >30). The overall rate of surgical complications was 4.0%, increasing from 2.4% for BMI <25 to 7.1% for BMI >45 (P = .006), with an adjusted odds ratio of 2.97 for BMI >45 versus BMI <25. The most common surgical complication was superficial surgical site infection; it was found in 2.9% of patients, increasing from 2.1% for BMI <25 to 5.1% for BMI >45 (P = .03). The medical complication rate was 0.6%, and the reoperation rate was 2.1%. There were no deaths. A maximal point analysis showed that BMI ≥39 was associated with a significantly higher complication rate, with an odds ratio of 2.38.


CONCLUSIONS
Reduction mammaplasty is a safe surgical procedure, even when performed on obese patients. However, patients with higher BMI have a greater risk of surgical site complications. This risk should be discussed preoperatively with obese patients.
Dr Gust is a resident physician, Mr Smetona is a medical student, Mr Hanwright is a medical student, and Drs Fine and Kim are attending physicians, Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
Madeleine J
MJ
Gust
John T
JT
Smetona
J Scott
JS
Persing
Philip J
PJ
Hanwright
Neil A
NA
Fine
John Y S
JY
Kim
D000328:Adult; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000009:adverse effects; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
National Surgical Quality Improvement Program; body mass index; breast reduction; breast surgery; complications; obesity; reduction mammaplasty