The Impact of Age on Outcomes Following Reduction Mammaplasty

Age-related physiological changes may influence surgical outcomes following breast reduction. This study investigates the association between patient age and postoperative complications using a large institutional cohort.

We retrospectively reviewed 985 patients who underwent bilateral reduction mammaplasty between 2002 and 2024 by a single surgeon. Patients were stratified by age into 3 groups: <31, 31 to 50, and >50 years. Baseline demographics, comorbidities, surgical techniques, and complication rates were analyzed. Univariable and multivariable logistic regression was used to assess associations between age and minor and major complications, adjusting for diabetes, hypertension, smoking history, and prior radiation.

Our patient cohort's mean age was 39.3 (13-76) years. A total of 276 (28.0%) had either a minor or major complication. The minor complications across the cohort (154) included seroma, skin necrosis, delayed wound healing, infection, nipple necrosis, hematoma, and fat necrosis. Major complications (122) included cases requiring readmission and/or reoperation. Patients in the 31- to 50-year age group were more likely to have a minor complication (17.9%) compared to those in the <31-year age group (13.1%) ( P = 0.05). Patients aged 31 to 50 years (13.0%) and >50 years (18.7%) were more likely to develop major complications than those aged <31 years (6.56%) ( P < 0.05 and P = 0.0001, respectively). The >50-year age group was more likely to be readmitted (7.4% vs 1.3%, P = 0.05) and reoperated (11.3% vs 5.3%, P < 0.05) compared to the <31-year age group. However, no statistically significant relationship was found with minor or major complication rates in senior groups with age ≥ 60 years. In adjusted models, age was not an independent predictor of minor or major complications; instead, diabetes (minor; odds ratio, 1.80; 95% confidence interval, 1.04-3.07; P = 0.03) and smoking (major; odds ratio, 2.16; 95% confidence interval, 1.12-3.98; P = 0.02) were associated with increased risk.

Older patients show higher unadjusted morbidity after reduction mammaplasty, but age itself is not an independent risk factor once comorbidities are considered. Preoperative counseling and optimization should prioritize diabetes, hypertension, and smoking over rigid age thresholds.