Investigating the Impact of Operative Time on Breast Augmentation Outcomes.

[BACKGROUND] Breast augmentation is a widely performed aesthetic surgery, yet the impact of operative time on postoperative outcomes remains unclear. While longer operative times have been linked to increased risks across a wide array of surgical disciplines, this association has not been thoroughly validated in breast augmentation. This multi-institutional study aims to investigate the relationship between operative time and outcomes after breast augmentation with implants.

[METHODS] The American College of Surgeons National Surgical Quality Improvement Program database (2008-2022) was queried to identify adult female patients who underwent elective breast augmentation with implants. Preoperative, intraoperative, and postoperative variables, including operative time and 30-day complications, were evaluated. Multivariable logistic regression was used to assess the impact of operative time, analyzing it as both a continuous and a dichotomized variable.

[RESULTS] A total of 6531 female patients with a mean age of 34.9 ± 10.1 years and a mean body mass index of 22.9 ± 4.0 kg/m 2 were included. One hundred eighteen patients (1.8%) experienced complications, the majority of which were reoperations (n = 69; 1.1%) and surgical complications (n = 30; 0.5%). Multivariable analysis revealed a significant association between operative time and both surgical complications (odds ratio [OR] = 1.01, P = 0.0003) and any complications (OR = 1.01, P = 0.003). For every 10-minute increase in operative time, the risk of surgical and any complications increased by 7.2% and 4.5%, respectively. A critical threshold of 91 minutes was identified, beyond which the odds of complications increased significantly (OR = 1.93, P = 0.001).

[CONCLUSIONS] Prolonged operative time is associated with an increased risk of complications following breast implant augmentation. A threshold of 91 minutes was identified, implying that procedures exceeding this duration carry higher postoperative morbidity. These findings underscore the importance of optimizing surgical efficiency to minimize risks and enhance patient outcomes after breast augmentation.