Exploring the Rise in Adolescent Reduction Mammaplasty: An 11-Year National Analysis.

Abstract

As the obesity epidemic continues to grow, symptomatic macromastia at earlier ages has become increasingly common. The present study aims to explore trends, risk factors, and postoperative complications in adolescent reduction mammaplasty (ARM) over an 11-year period. The American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) was queried to identify ARM cases between 2012-2022 in patients 18 years or younger. Patient demographics, procedure details, and postoperative outcomes were collected. Trend analysis and predictors for postoperative complications were performed via linear regression and multivariable logistic regression, respectively. Between 2012 and 2022, 3158 patients underwent ARM. The overall complication rate was 4.4%, with superficial surgical site infections at 3.0%. Among those who underwent ARM, elevated body mass index (adjusted odds ratio 1.04, P < 0.001) and higher American Society of Anesthesiologists (ASA) class predicted complications (ASA1: adjusted odds ratio 0.34, P = 0.01). The prevalence of ARM increased by 482%, while overall obesity rates increased by 58% over the years. Total operation time ( P = 0.005), anesthesia duration ( P = 0.02), and length of stay ( P < 0.001) decreased throughout the years, while superficial surgical site infections increased ( P = 0.04). As obesity rates rise, the prevalence of ARM has increased even more rapidly, with elevated body mass index and higher ASA individuals at an increased risk for complications. Operative time, anesthesia duration, and length of stay decreased over time, with low overall complication rates. Plastic surgeons should note these trends to provide adequate care for patients requesting ARM.