Resident participation in reduction mammaplasty: Safe, efficient, and equivalent in patient satisfaction.

Abstract

Breast reduction surgery is one of the most common procedures in plastic surgery and a cornerstone of resident training. While its safety and benefits are well established, the impact of resident participation on surgical outcomes and patient satisfaction remains underexplored. A retrospective single-center study was conducted between January 2019 and January 2023, including 208 patients (416 breasts) who underwent bilateral reduction mammaplasty using an inverted-T technique. Procedures were performed either by a senior surgeon alone (S group, n = 56) or by a senior surgeon assisted by a resident (S+R group, n = 152). Perioperative outcomes, postoperative complications, and risk factors were analyzed. Patient-reported outcomes were assessed using the BREAST-Q Version 2.0 Reduction Module and compared to normative data. Resident participation significantly reduced operative time (134.9 ± 29.8 vs 158.2 ± 24.6 min; p < 0.001) without increasing complication rates (35.5% vs 41.1%; p = 0.46) or wound dehiscence. Multivariate analysis identified only resection weight >650 g as an independent predictor of complications (OR = 2.23; 95% CI [1.20-4.20]; p = 0.012). BREAST-Q scores were comparable between groups, with slightly higher values in the S+R group. Satisfaction with breasts was significantly higher than normative data in both groups (p = 0.0347 and p < 0.001, respectively). In a highly supervised academic setting involving intermediate-level residents, resident participation in breast reduction surgery is safe and efficient and preserves patient satisfaction. These findings support structured resident integration without suggesting a direct performance benefit attributable to resident participation.