Perioperative Outcomes and Risk Profile of 4730 Cosmetic Breast Surgery Cases in Academic Institutions: An ACS-NSQIP Analysis

Abstract Background Cosmetic breast surgery (CBS) can be subdivided into augmentation, mastopexy, reduction, and reconstruction. Objectives The aim of this study was to retrospectively analyze a multi-institutional national database to investigate the outcomes of CBS and identify clinical patterns t...

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Published in:Aesthetic surgery journal 2023-03, Vol.43 (4), p.433-451
Main Authors: Knoedler, Samuel, Kauke-Navarro, Martin, Haug, Valentin, Broer, P Niclas, Pomahac, Bohdan, Knoedler, Leonard, Panayi, Adriana C
Format: Article
Language:English
Subjects:
Adult
Aged
Breast Neoplasms
Diabetes Mellitus
Female
Humans
Obesity - complications
Obesity - epidemiology
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Pulmonary Disease, Chronic Obstructive
Quality Improvement
Retrospective Studies
Risk Factors
United States - epidemiology
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Summary:Abstract Background Cosmetic breast surgery (CBS) can be subdivided into augmentation, mastopexy, reduction, and reconstruction. Objectives The aim of this study was to retrospectively analyze a multi-institutional national database to investigate the outcomes of CBS and identify clinical patterns to optimize care. Methods The American College of Surgeons National Surgical Quality Improvement Program database (2008-2020) was reviewed to identify female patients who underwent CBS. Postoperative outcomes (30-day surgical and medical complications, reoperation, readmission, and mortality) and risk factors for complications were assessed. Results In total, 4733 patients were identified (mean age, 40 [13] years; mean BMI, 24 [4.5] kg/m2) with augmentation accounting for 54% of cases. There were complications in 2.0% of cases. Age >65 years (P = .002), obesity (P < .0001), setting (P < .0001), and diabetes (P = .04) were risk factors for any complication. Age >65 years (P = .02), obesity (P = .03), diabetes (P = .01), history of chronic obstructive pulmonary disease (COPD) (P = .002) and congestive heart failure (P < .0001), smoking in the past year (P = .003), setting (P = .007), and increased American Society of Anesthesiology score (P < .0001) were predictors of surgical complications such as dehiscence and infection. Multivariable analysis confirmed that chronic obstructive pulmonary disease, obesity Class 1 and 3, and inpatient status were independent risk factors for occurrence of any complication (P = .0005, .0003, < .0001 and
ISSN:1090-820X
1527-330X
DOI:10.1093/asj/sjac320