Pilot Study: Impact of Obesity on Complications and Outcomes in Reduction Mammoplasty

Reduction mammoplasty is commonly performed for macromastia to alleviate physical and psychological symptoms. The impact of obesity on postoperative complications remains controversial. This study assessed the association between body mass index (BMI) and complication rates following reduction mammoplasty and evaluated clinical outcomes, including operative characteristics, postoperative complications, and patient satisfaction.

A retrospective chart review was conducted on female patients who underwent reduction mammoplasty at King Khalid University Hospital between September 2015 and April 2024. Demographic, clinical, intraoperative, and postoperative data were collected using a structured data sheet. Patients were categorized according to BMI. Statistical analysis included χ² tests, Kruskal-Wallis tests, and multivariable regression to identify predictors of complications and satisfaction.

A total of 99 patients were included. Most were classified as overweight (n = 36, 36.4%) or obesity class I (n = 39, 39.4%). The inferior pedicle technique was used in 75 (75.8%) cases. Operation time differed significantly across BMI categories (P = 0.048), with longer durations in higher BMI classes. Delayed complications occurred in 24 (24.2%) patients, most commonly wound dehiscence (n = 13, 54.2%). Multivariable regression identified respiratory comorbidities as a significant predictor of increased complications (β = 0.93; P = 0.007). BMI was not significantly associated with complication rates or satisfaction scores.

Obesity was not independently associated with increased complications or reduced satisfaction following reduction mammoplasty. Respiratory comorbidities, however, were associated with higher complication rates. These findings support individualized surgical planning and highlight the importance of optimizing comorbid conditions preoperatively.