Reduction mammoplasty in adolescents and elderly: A ten year case series analyzing age related outcome with focus on safety and complications.

Introduction: Reduction mammoplasty alleviates symptoms of macromastia in various ways. Current study results mainly identify perioperative risk factors for middle aged patients. We investigated a large series of consecutive breast reductions procedures to study whether patients' age at the time of operation is related to the postoperative outcome.

Methods: We retrospectively reviewed all non-oncologic breast reduction procedures at a single institution over a ten year time period, analyzing patients (age, BMI, comorbidities, medication) and operation specific characteristics' (pedicle, nipple-to-sternal notch, resection weight, complications) to identify risk factors related to patients' age at the time of operation. Patients were therefore divided into three groups, according to their age (group I ≤ 20 years, group II ≥60 years, group III 21 to 59 years).

Results: 539 patients were included in the study, in total 1065 reduction mammoplasties were performed over a ten year period. The overall complication rate was 33% (n = 175). Excluding minor complications, the total complication rate was 9.5% (n = 51). High body mass index (≥30 kg/m2) (p = 0.02) could be identified as a statistically significant risk factor for major and minor complications. Smoking (p = 0.09) and age ≥ 60 years (p = 0.08) showed a tendency toward higher risk for major and minor complications.

Conclusion: This study shows an increased risk for complications when performing reduction mammoplasty in older patients, presumably due to the higher prevalence of comorbidities in this patient group as compared to young patients.