Body weight and age can affect complication risk after breast reduction, according to a report in the April 2023 edition of Plastic and Reconstructive Surgery.
"While reduction mammaplasty is a safe procedure, our study suggests that patients in higher BMI categories may take longer to heal, with increased risk of wound healing times longer than two months," lead author Dr. Jesse Payton said in a journal news release. Payton is a researcher at Baylor Scott & White Medical Center in Temple, Texas.
Reduction mammaplasty is used to reduce back and neck pain and to improve body image and low self-esteem in women with breasts considered overlarge.
For the study, researchers reviewed data on 277 patients who underwent reduction mammaplasty between 2014 and 2018.
Patients’ average age was 36. Average BMI (body mass index) was 30 -- the low end of obesity.
Despite being at this high-BMI cutoff point, the patients were generally healthy, with low rates of other health problems, according to the study.
About 49% of patients whose cases were reviewed had minor complications, such as superficial wound-healing problems. Major complications were uncommon, occurring in a little more than 4% of patients.
On initial analysis, BMI was unrelated to the risk of minor or major complications, but patients in higher BMI categories were more likely to have delayed wound healing, with healing times longer than two months.
Higher-BMI patients also had longer surgical times and greater amounts of tissue removed at surgery, according to the study.
Older age was also associated with an increased rate of minor complications.
The greatest increase in delayed wound healing happened at the highest BMI levels. With every increase in BMI by 5, the estimated odds of delayed wound healing increased by 77%. There was also a positive trend relating high BMI and risk of major and minor complications.
Older age on its own was a risk factor for minor complications. For each decade of age, the estimated odds of minor complications increased by 22%.
Patients should be counseled about the BMI- and age-related increase in risks, the authors said. Taking steps to optimize patients' health before surgery might help to reduce complication risks in the heaviest patients.
"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 two months,” the authors concluded.
"While BMI is an important consideration for determining operative candidacy, the benefits of reduction may outweigh these risks in carefully selected patients,” they said.
The U.S. National Heart, Lung, and Blood Institute has more on body mass index.
SOURCE: Plastic and Reconstructive Surgery, news release, March 30, 2023