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The Impact of Resident Postgraduate Year Involvement in Body-Contouring and Breast Reduction Procedures

A Comprehensive Analysis of 9638 Patients

Malyar, Masoud, MD*†; Peymani, Abbas, MD, MS*; Johnson, Anna Rose, MPH*; Chen, Austin D.*; Van Der Hulst, René R. W. J., MD, PhD; Lin, Samuel J., MD, MBA*

doi: 10.1097/SAP.0000000000001714

Given the rising popularity in body-contouring procedures (BCPs) in the United States, it is important to assess the currently unknown association between resident involvement and postoperative complications. As such, the aim of this study was to evaluate the impact of resident involvement on outcomes in BCPs using a large national database.

Methods A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database was performed (2006–2012) to identify patients undergoing BCPs, using relevant Current Procedural Terminology codes. Outcome measures included postoperative complications, hospital length of stay, and operation time.

Multivariate regression models were used to assess the impact of resident involvement and resident experience on outcomes.

Results A total of 9638 cases were identified, of which 3311 involved resident participation.

Resident involvement was associated with significantly higher rates of complications (7.8% vs 4.4%; P = 0.003) and longer operation times (180.7 vs 171.9 minutes; P = 0.005). For each year increase of resident postgraduate year, there was a significant decrease in odds of complications (odds ratio, 0.906; P = 0.013) and operative time (−2.7 minutes; P = 0.001).

Conclusions Resident involvement in BCPs was associated with an increased rate of overall complications in a large, national database. However, the clinical significance of these outcomes may be debated. Increased postgraduate year experience as a surgical resident was inversely associated with overall complications. Guided resident autonomy and earlier exposure to BCPs could lead to an optimization of clinical outcomes and resident education.

From the *Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and

Department of Plastic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

Received May 4, 2018, and accepted for publication, after revision September 25, 2018.

Masoud Malyar and Abbas Peymani share the first authorship.

Conflicts of interest and sources of funding: none declared.

Reprints: Samuel J. Lin, MD, MBA, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Suite 5A, Boston, MA 02215. E-mail:

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