Incidence and risk factors for venous thromboembolism in bilateral breast reduction surgery: An analysis of the National Surgical Quality Improvement Program

American Society of Plastic Surgeons Evidence-Based Clinical Practice Guideline Revision: Reduction Mammaplasty

“…For example, in a nationwide registry of 5371 women who underwent a reduction mammaplasty, as age increased there was a significant increase in postoperative thromboembolic events (deep venous thrombosis, pulmonary embolism). 36 Conversely, Sutinen et al 43 found no association of age with complications in a Finnish cohort of 483 patients. The National Surgical Quality Improvement Program database with 13,503 breast reduction patients was analyzed by Hillam et al, 40 who found no association between patient age and complications.…”

“…However, there were a few studies that looked at the incidence of specific complications following reduction mammaplasty such as infection, thromboembolic events, fat necrosis, hematoma, or seroma formation, in which there was no increased incidence in smokers. 36,39,47,48,[51][52][53] Overall, moderate quality evidence was found to support the recommendation (moderate strength) that patients should be informed preoperatively of the increased risks of complications including infection, T-junction necrosis, and wound complications with simultaneous smoking and reduction mammaplasty. These studies showed increased odds of complications from two to five times the risk compared to nonsmokers.…”

“…There was no association identified between diabetes mellitus (type 1 or 2) and complications of reduction mammaplasty with studies available for review. 36,37,42,43,46 It is important to note that the incidence of diabetes mellitus in the studies was fairly low, ranging from 1 to 4.7 percent, and may represent inclusion of medically optimized patients with well-controlled diabetes mellitus. In contrast, diabetes mellitus is often associated with other comorbidities (such as morbid obesity) that may preclude patients from undergoing elective reduction mammaplasty surgery, especially when glucose levels are poorly controlled.…”

“…Overall, six studies have shown increased risk of complications in older women. [33][34][35][36][37][38] Five studies failed to demonstrate age as a significant risk factor for any complication. [39][40][41][42][43] One study showed an association between older age and a reduced risk of delayed wound healing.…”

“…However, there were a few studies that looked at the incidence of specific complications following reduction mammaplasty such as infection, thromboembolic events, fat necrosis, hematoma, or seroma formation, in which there was no increased incidence in smokers. 36,39,47,48,51–53…”