How Does Operative Time Affect Outcomes in Breast Reduction Surgery?

Reduction mammaplasty is a surgical procedure performed to treat individuals with macromastia. It has been shown that a greater risk of complication is associated with higher body mass indices (BMIs). Other factors such as operative time have not been as well-studied. We sought to investigate the effect of surgery length, as well as surgeons themselves, on outcomes of a common plastic surgery operation. A retrospective chart review from a single academic institution's main teaching hospital of patients who underwent bilateral reduction mammaplasty during January 2020 to August 2024 was conducted. Multivariable regression was used to assess complications based on operative time, BMI, and surgeon. Receiver operating characteristic analysis was subsequently employed to determine the optimal model for prediction of complications. There were 102 patients included in the study. They had an average BMI of 33.4 and length of surgery of 229.7 min, the latter of which varied significantly between surgeons, with an overall complication rate of 24.5%. Longer operative times, with BMI and surgeon controlled, did not significantly increase complications (95% CI for OR = [0.99, 1.01]). However, all three variables together did significantly discriminate between the presence and absence of complications (AUC = 0.65, P = 0.04). The data do not suggest that operative time alters the complication rate, but rather indicate that the addition of the surgeon to a predictive model that contains operative time and BMI creates a meaningful way to discriminate the presence of complications. As such, this study highlights the importance of the surgeon's role in reduction mammaplasty.