Abstract / Summary
Abstract Background Age is frequently cited as a surgical risk factor; yet, its influence on outcomes following breast reduction remains unclear. With increasing numbers of elderly patients presenting with macromastia, determining whether advanced age independently affects complication rates is clinically important. Aims and Objectives To evaluate whether age ≥ 65 years is an independent risk factor for postoperative complications following bilateral reduction mammaplasty and to identify associated patient- and procedure-related variables. Materials and Methods This retrospective cohort study included 1716 female patients who underwent bilateral breast reduction at a single tertiary center (2005–2024), stratified into older (≥ 65 years, n = 174), and non-older (< 65 years, n = 1542) groups. Primary outcome was Clavien–Dindo grade II or higher complications requiring surgical intervention. Multivariable logistic regression identified independent risk factors. Results Older patients had significantly higher comorbidity prevalence (69.0% vs. 46.1%; p < 0.001), including diabetes and hypertension, and greater bilateral resection weights. Despite this, overall complication rates were significantly lower in the older group (8.6% vs. 16.1%; OR 0.49, 95% CI 0.28–0.85; p = 0.009). Hematoma and deep wound infection rates were also lower, while fat necrosis occurred more frequently and was managed conservatively in most cases. On multivariable analysis, higher BMI (OR 1.10; p = 0.004) and active smoking (OR 1.80; p = 0.004) were independent predictors of complications; age ≥ 65 was not significantly associated with complications (OR 0.55; p = 0.062). Conclusions Advanced age alone was not independently associated with increased complications. BMI and smoking were the main modifiable factors associated with postoperative risk. Age-based exclusion criteria are not supported by these findings in this cohort of selected surgical patients; individualized risk assessment should be applied to all candidates. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .