A Multi-Institutional Perspective of Complication Rates for Elective Nonreconstructive Breast Surgery: An Analysis of NSQIP Data From 2006 to 2010

Hanwright, Philip J.; Hirsch, Elliot M.; Seth, Akhil K.; Chow, Geoffrey; Smetona, John; McNichols, Colton H.; Gaido, Jessica; Fine, Neil A.; Bilimoria, Karl Y.; Kim, John Y.S.

doi:10.1177/1090820x13478819

Cited by 35 publications

(15 citation statements)

References 37 publications

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“…Furthermore, the UR rate for breast reconstruction by tissue expander (CPT 19357) alone was 5.8%, weighing heavily on the overall UR rate. The most commonly performed procedure in this study was reduction mammaplasty with an overall UR rate of 1.2%, in agreement with previously reported re-operation rates [23]. Despite these minor differences, the 1.9% UR rate remains acceptably low compared to the rates reported across all specialties (0.6-11%) [1][2][3][8][9][10][11][12][13][14][15].…”

Section: Discussionsupporting

confidence: 89%

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Lim

Jordan

Jain

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Studies that evaluate the predictors and causes of unplanned re-operation in outpatient plastic surgery. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all plastic surgery outpatient cases performed in 2011. Multiple logistic regression analysis was utilised to identify independent risk factors and causes of unplanned reoperations. Of the 6749 outpatient plastic surgery cases identified, there were 125 (1.9%) unplanned re-operations (UR). Regression analysis demonstrated that body mass index (BMI, OR = 1.041, 95% CI = 1.019-1.065), preoperative open wound/wound infection (OR = 3.498, 95% CI = 1.593-7.678), American Society of Anesthesiologists (ASA) class 3 (OR = 2.235, 95% CI = 1.048-4.765), and total work relative value units (RVU, OR = 1.014, 95% CI = 1.005-1.024) were significantly predictive of UR. Additionally, the presence of any complication was significantly associated with UR (OR = 15.065, 95% CI = 5.705-39.781). In an era of outcomes-driven medicine, unplanned re-operation is a critical quality indicator for ambulatory plastic surgery facilities. The identified risk factors will aid in surgical planning and risk adjustment.

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Section: Discussionsupporting

confidence: 89%

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Lim

Jordan

Jain

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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“…Rates of complications as reported in the literature are highly variable, ranging from 1% to 38%, depending on the definition. 34,36–40 Similar to our transfeminine cohort, the most common complication in the cisgender group was reoperation secondary to hematoma formation, occurring in 0.8% of patients. This finding is consistent with retrospective studies from Handel 58 and Araco, 36 that reported hematoma formation in 1%–2% of patients.…”

Section: Discussionsupporting

confidence: 59%

Epidemiologic Characteristics and Postoperative Complications following Augmentation Mammaplasty: Comparison of Transgender and Cisgender Females

Cuccolo¹,

Kang²,

Boskey

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background:Breast augmentation in transgender women can be an important first step in addressing gender incongruence and improving psychosocial functioning. The aim of this study was to compare postoperative outcomes of augmentation mammoplasty in transgender and cisgender females.Methods:We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2017 to establish 2 cohorts: (1) transgender females undergoing gender-affirming breast augmentation (“top surgery”) and (2) cisgender females seeking cosmetic breast augmentation (CBA). Demographic characteristics and postoperative outcomes were compared between the 2 cohorts. Multivariable regression analysis was used to control for confounders.Results:A total of 1,360 cases were identified, of which 280 (21%) were feminizing top surgeries and 1,080 (79%) were CBA cases. The transfeminine cohort was significantly older, had a higher average body mass index, and was more racially diverse than the CBA cohort. Transfeminine patients also had higher rates of smoking, diabetes, and hypertension. The rates of all-cause complications were low in both cohorts, and differences were not significant (1.6% transfeminine versus 1.8% CBA, P = 0.890) for the first 30-days after operation. After controlling for confounding variables, transfeminine patients had postoperative complication profiles similar to their cisgender counterparts. Multivariable regression analysis revealed no statistically significant predictors for all-cause complications.Conclusions:Transfeminine breast augmentation is a safe procedure that has a similar 30-day complication profile to its cisgender counterpart. The results of this study should reassure and encourage surgeons who are considering performing this procedure.

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“…Breast augmentation is a relatively safe procedure. In a recent study of 725 patients who underwent augmentation, the overall complication rate was less than 1.5 percent and life-threatening complications were exceedingly rare (3). Of more utility in this patient population, is the evaluation of changes in quality of life, body image, patient satisfaction and self-esteem.…”

Section: Introductionmentioning

confidence: 99%

Normative Data for Interpreting the BREAST-Q: Augmentation

Mundy

Homa

Klassen

et al. 2017

Plastic &Amp; Reconstructive Surgery

100

138

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Background The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome (PRO) instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. Methods Normative data were generated for the BREAST-Q Augmentation Module via the Army of Women (AOW), an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited via email, with women 18 years or older without a history of breast cancer or breast surgery invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. Results The preoperative BREAST-Q Augmentation Module was completed by 1,211 women. Mean age was 54 ±24 years, mean body mass index (BMI) was 27 ±6, and 39% (n=467) had a bra cup size ≥D. Mean scores were Satisfaction with Breasts (54 ±19), Psychosocial Well-being (66 ±20), Sexual Well-being (49 ±20), and Physical Well-being (86 ±15). Women with a BMI of 30 or greater and bra cup size D or greater had lower scores. In comparison to AOW scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. Conclusions The AOW normative data represent breast-related satisfaction and well-being in woman not actively seeking breast augmentation. This data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population.

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A Multi-Institutional Perspective of Complication Rates for Elective Nonreconstructive Breast Surgery: An Analysis of NSQIP Data From 2006 to 2010

Cited by 35 publications

References 37 publications

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Epidemiologic Characteristics and Postoperative Complications following Augmentation Mammaplasty: Comparison of Transgender and Cisgender Females

Normative Data for Interpreting the BREAST-Q: Augmentation

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