Oral contraceptive pills and reduction mammoplasty: A retrospective cohort analysis

Oral contraceptive pills (OCPs) are commonly utilized by women aged 15-40 years. Despite being associated with an increased risk of thromboembolism, their potential impact on surgical outcomes, particularly in reduction mammoplasty, remains unknown. We aimed to explore the association between OCP use and outcomes following reduction mammoplasty.

A retrospective cohort study was conducted. An OCP group was defined by those who were taking oral contraceptive pills at the time of reduction mammoplasty and those in control group were not taking OCPs. Propensity score matching was carried out for age, race, previous delivery, and body mass index. Mastodynia, ptosis, fat necrosis, deformity/disproportion of the breast, hematoma/hemorrhage, and embolism/thrombosis that occurred within 6 months of surgery were documented.

Each cohort contained 8526 patients with a mean age of 31.7 years (SD: 11.5 years). Controls exhibited a 1.36-fold higher likelihood of hematoma/hemorrhage, with 195 (2.3%) cases. Controls experiencing the complication were compared to 143 (1.7%) individuals on OCPs (CI:1.10-1.68; p<0.01). However, the OCP group did not demonstrate an increased risk for developing an embolism or thrombosis, with 32 (.38%) experiencing the complication compared to 35 (.41%) controls (RR=.91; CI:.57-1.48; p=.71). No statistical difference was found in mastodynia (p=.10), ptosis (p=.15), fat necrosis (p=.54), or deformity or disproportion/reconstructed breast (p=.32).

Discontinuation of OCPs prior to reduction mammoplasty would not offer any discernible advantages in postoperative outcomes. The decision to continue or discontinue OCPs before reduction mammoplasty should be based on patient-specific factors, rather than on reducing the risks associated with the procedure.