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METHODS: Patients in the National Surgical Quality Improvement Program (NSQIP) participant use file who underwent elective, non-reconstructive breast surgery between 2006 and 2010 were identified. Twenty defined morbidities were compared among mastopexy (CPT 19316), reduction mammaplasty (CPT 19318), and augmentation mammaplasty (CPT 19325) procedures using ANOVA and chi-squared tests for continuous variables and categorical variables, respectively.
RESULTS: Of the 4,272 patients identified, 654 underwent mastopexy, 2,779 underwent reduction mammaplasty, and 839 underwent augmentation mammaplasty. Patients undergoing augmentation mammaplsty had the lowest overall complication rate compared to mastopexy and reduction mammaplasty (1.43% vs. 2.75% vs. 4.64%). Patients undergoing reduction mammaplasty had significantly higher incidences of overall morbidity, superficial surgical site infections (SSI), and wound disruptions (P < .05). Thirty day reoperation rates for mastopexy, reduction mammaplasty, and augmentation mammaplasty were low (2.60%, 1.94%, and 1.19%) as were the rates of life threatening complications (0.15%, 0.18%, and 0%). Only one mortality and three instances of DVT/PE were observed in all 4,272 procedures with neither subgroup having a significant difference.
CONCLUSION: Elective breast surgery is a safe procedure with few incidences of life threatening complications and mortality; however, reduction mammaplasty is associated with elevated rates of morbidity. Comprehensive data collated from the NSQIP multi-institutional initiative will help manage patient education and expectations on potential deleterious outcomes.