Evaluation of Preoperative Risk Factors and Complication Rates in Cosmetic Breast Surgery

被引:50
作者
Hanemann, Michael S., Jr. [1 ,2 ]
Grotting, James C. [3 ,4 ]
机构
[1] Louisiana State Univ, Hlth Sci Ctr, Div Plast & Reconstruct Surg, New Orleans, LA USA
[2] Tulane Univ, Hlth Sci Ctr, Div Plast & Reconstruct Surg, New Orleans, LA 70118 USA
[3] Univ Alabama, Div Plast & Reconstruct Surg, Birmingham, AL USA
[4] Univ Wisconsin, Dept Plast & Reconstruct Surg, Madison, WI USA
关键词
cosmetic breast surgery; complications; infection; preoperative risk factors; obesity; smoking; diabetes; breast augmentation; mastopexy; breast reduction; REDUCTION MAMMAPLASTY; SMOKING; SAFETY;
D O I
10.1097/SAP.0b013e3181cdabf8
中图分类号
R61 [外科手术学];
学科分类号
摘要
To assess the relationships between body mass index, smoking, and diabetes and postoperative complications after cosmetic breast surgery, based on patient claims made to CosmetAssure, a program which provides coverage for treatment of significant complications, which might not be reimbursed by patients' health insurance carriers. Complication rates of cosmetic breast operations were reviewed from 13,475 consecutive patients between April 1, 2008 and March 31, 2009. Correlations between complication rates and risk factors of body mass index >= 30, smoking, and diabetes were analyzed. Because this insurance program reimburses patients for costs associated with the treatment of postsurgical complications, physicians are incentivized to report significant complications. A "significant" complication is defined as a postsurgical problem, occurring within 30 days of the procedure that requires admission to a hospital, emergency room, or surgery center. Minor complications that were treated in the outpatient setting are not included, as their treatment did not generate an insurance claim. According to patient claims data between April 1, 2008 and March 31, 2009, the overall complication rate for cosmetic breast surgery was 1.8%. Obese patients ( body mass index >= 30) undergoing breast augmentation and augmentation mastopexy demonstrated higher complication rates than nonobese patients. Patients with diabetes undergoing augmentation mastopexy experienced higher complication rates than nondiabetics. Data collection is ongoing, and as the number of cases increases (approximately 1300 new cosmetic breast surgeries per month), multiple other trends in this study will likely achieve statistical significance. Analysis of CosmetAssure data can accurately and objectively track the rate of significant postoperative complications secondary to cosmetic surgical procedures. As the number of risk factors increase, the risk of complications increases. Cosmetic breast surgery is extremely safe, with low infection and overall complication rates. Plastic surgeons can further decrease complications through careful patient selection.
引用
收藏
页码:537 / 540
页数:4
相关论文
共 20 条
[1]   A retrospective analysis of 3,000 primary aesthetic breast augmentations: Postoperative complications and associated factors [J].
Araco, A. ;
Gravante, G. ;
Araco, F. ;
Delogu, D. ;
Cervelli, V. ;
Walgenbach, K. .
AESTHETIC PLASTIC SURGERY, 2007, 31 (05) :532-539
[2]  
*ASAPS, 2008, ASAPS COSM SURG NAT
[3]   Reduction mammaplasty: Symptoms, complications, and late results - A retrospective study on 242 patients [J].
Atterhem, H ;
Holmner, S ;
Janson, PE .
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY, 1998, 32 (03) :281-286
[4]   Is it justified to refuse breast reduction to smokers? [J].
Bikhchandani, J. ;
Varma, S. K. ;
Henderson, H. P. .
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 2007, 60 (09) :1050-1054
[5]   Smoking and wound healing problems in reduction mammaplasty - Is the introduction of urine nicotine testing justified? [J].
Chan, LKW ;
Withey, S ;
Butler, PEM .
ANNALS OF PLASTIC SURGERY, 2006, 56 (02) :111-115
[6]   Patient safety in the office-based setting [J].
Clayman, Mark A. ;
Seagle, M. Brent .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2007, 119 (03) :1128-1129
[7]   Analysis of breast reduction complications derived from the BRAVO study [J].
Cunningham, BL ;
Gear, AJL ;
Kerrigan, CL ;
Collins, ED .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2005, 115 (06) :1597-1604
[8]  
Horton JB, 2006, PLAST RECONSTR SURG, V117, p61E, DOI 10.1097/01.prs.0000204796.65812.68
[9]  
Hunter John G, 2006, Aesthet Surg J, V26, P153, DOI 10.1016/j.asj.2006.01.002
[10]   Vertical mammaplasty: Early complications after 250 personal consecutive cases [J].
Lejour, M .
PLASTIC AND RECONSTRUCTIVE SURGERY, 1999, 104 (03) :764-770