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Increasing Age Impairs Outcomes in Breast Reduction Surgery

Shermak, Michele A. M.D.; Chang, David Ph.D., M.P.H., M.B.A.; Buretta, Kate M.D.; Mithani, Suhail M.D.; Mallalieu, Jessie P.A.-C.; Manahan, Michele M.D.

Plastic and Reconstructive Surgery: December 2011 - Volume 128 - Issue 6 - p 1182–1187
doi: 10.1097/PRS.0b013e318230c467
Breast: Original Articles
Press Release

Background: Although multiple breast reduction outcomes studies have been performed, none has specifically identified the impact of advanced age. The authors aimed to study the impact of age on breast reduction outcome.

Methods: Medical records for all patients billed for Current Procedural Terminology code 19318 over the past 10 years (1999 to 2009) at a large academic institution were analyzed under an institutional review board–approved protocol. A total of 1192 consecutive patients underwent 2156 reduction mammaplasties performed by 17 plastic surgeons over a 10-year period. Breast reduction techniques included inferior pedicle/Wise pattern in 1250 patients (58.9 percent), medial pedicle/Wise pattern in 360 (16.9 percent), superior pedicle/nipple graft in 305 (14.4 percent), superior pedicle/vertical pattern in 206 (9.7 percent), and liposuction in three (0.14 percent). The average patient age was 36 years. Age groups were divided into younger than 40 years, 40 to 50 years, and older than 50 years. Multiple logistic regression analysis was performed to identify significant relationships.

Results: Women older than 50 years more likely experienced infection (odds ratio, 2.7; p = 0.003), with trends toward wound healing problems (odds ratio, 1.6; p = 0.09) and reoperative wound débridement (odds ratio, 5.1; p = 0.07). There was a trend toward infection in women aged 40 to 50 years (odds ratio, 1.7; p = 0.08). Advanced age did not exacerbate fat necrosis or seroma development.

Conclusions: Age older than 50 years impairs breast reduction outcomes, particularly infection, and may negatively impact wound healing. Hormonal deficiency may partially account for this finding.


Baltimore, Md.

From the Division of Plastic Surgery and the Department of Surgery, The Johns Hopkins Medical Institutions.

Received for publication November 4, 2010; accepted April 19, 2011.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Michele A. Shermak, M.D.; The Plastic Surgery Center of Maryland, 1304 Bellona Avenue, Lutherville, Md. 21093,

©2011American Society of Plastic Surgeons