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Postoperative Outcomes After Breast Reduction: Do Racial Disparities Exist?
Samuel Knoedler1,2, Thomas Schaschinger3, Harriet Kiwanuka1
1Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Journal of Racial and Ethnic Health Disparities
|June 27, 2025
Summary
Reduction mammoplasty is safe, but racial disparities exist. Black/African American patients had fewer overall complications but higher risks for deep infections and readmissions, while Asian patients had fewer surgical complications.
Area of Science:
- Plastic Surgery
- Health Services Research
- Health Equity
Background:
- Racial disparities in surgical outcomes are documented in oncological and reconstructive breast surgery.
- It is unclear if these disparities extend to reduction mammoplasty procedures.
Purpose of the Study:
- To investigate racial disparities in 30-day postoperative outcomes following reduction mammoplasty.
- To compare outcomes across different racial groups, including Asian, Black/African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, and White patients.
Main Methods:
- Utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011-2022.
- Included adult female patients undergoing reduction mammoplasty.
- Compared 30-day postoperative outcomes using univariate and multivariate analyses, adjusting for confounders.
Main Results:
- The study included 26,329 patients; 64% White, 34% Black/African American, 1.2% Asian, 0.41% American Indian/Alaska Native, and 0.35% Native Hawaiian/Pacific Islander.
- Overall complication rate was 6.3%, ranging from 4.0% in Asian patients to 6.5% in White patients.
- Black/African American patients had lower overall and surgical complication risks but higher risks for deep incisional infections and readmissions. Asian patients had lower surgical complication risks.
Conclusions:
- Reduction mammoplasty demonstrates a strong safety profile across all racial groups.
- Subtle racial disparities in postoperative outcomes were observed, particularly for Black/African American and Asian patients.
- Further research is needed to understand the factors contributing to these differential outcomes in reduction mammoplasty.
