Comparative outcomes and safety of reduction mammoplasty performed by plastic and general surgeons: a 20-year retrospective cohort study of 1716 patients
In brief
General surgeons match plastic surgeons' 15% complication rate in breast reduction
In this single-center review of 1,716 patients, overall complications after breast reduction were nearly identical for general and plastic surgeons: about 15% in each group. Wound separation was more frequent in the plastic-surgeon group, but differences in patient selection or surgical practice could explain the results; larger prospective studies are needed to confirm they apply elsewhere.
- Journal
- Updates in surgery (Q1)
- Published
- 30 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Iselin Saltvig, Salvatore Giordano
- PMID
- 42961552
- DOI
- 10.1007/s13304-026-02926-x
Why clinicians should know about it
- Picked for Plastic and Reconstructive Surgery (top studies of the week, 1 November 2026): Comparative clinical outcomes of reduction mammoplasty
Abstract
INTRODUCTION: Reduction mammoplasty (RM) is traditionally performed by plastic surgeons (PS), but an increasing number of procedures are now undertaken by general surgeons (GS). While all PS receive formal training in RM, training among GS is variable, and comparative outcomes between these specialties remain limited. The aim of this study was to evaluate and compare perioperative outcomes of RM performed by PS versus GS. METHODS: This retrospective, single-center cohort study included consecutive patients who underwent bilateral RM between 2005 and 2024. Patients were categorized according to the primary surgeon's specialty (PS or GS). Demographic characteristics, perioperative parameters, postoperative complications, and the need for revision surgery were collected. RESULTS: A total of 1716 patients were included: 1335 in the PS group and 381 in the GS group. Mean age was similar between groups (44.3 vs. 44.8 years, p = 0.485). PS patients had slightly higher body mass index (BMI, 27.4 vs. 26.9 kg/m2, p = 0.015). Operative time was longer in the PS group (130.4 vs. 112.2 min, p = 0.001), while intraoperative blood loss was higher in the GS group (300.9 vs. 279.0 mL, p = 0.047). Overall postoperative complication rates were comparable (15.4% vs. 15.2%, p = 0.921), although wound dehiscence occurred more frequently in the PS cohort (7.5% vs. 2.1%, p < 0.001). CONCLUSIONS: These findings suggest RM performed by GS yields complication rates comparable to PS within this single-center cohort. Differences in operative technique, patient selection, and perioperative management may explain outcome similarities, though residual confounding remains possible. Larger, prospective studies are needed to confirm broader generalizability.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.