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Original Article Plastic and Aesthetic Research

A propensity score matched analysis of

obesity as an independent risk factor for

postoperative complications in reduction

mammaplasty

James D. Goggin , Stacy Wong , Jessica E. Pruszynski , Jon P. Ver Halen 1
1
2
1
1 Division of Plastic Surgery, Department of Surgery, Baylor Scott & White Health, Temple, TX 76513, USA.
2 Department of Biostatistics, Baylor Scott & White Health, Temple, TX 76513, USA.
Corresponding Author: Dr. Jon P. Ver Halen, Division of Plastic Surgery, Department of Surgery, Baylor Scott & White Health, Temple,
TX 76513, USA. E-mail: jon.verhalen@bswhealth.org

Dr. Jon P. Ver Halen is currently an Associate Professor with the Texas A&M School of Medicine, Department
of Surgery. He is also Associate Program Director of the Plastic Surgery Residency, and Program Director of the
Microvascular Surgery Fellowship.

ABSTRACT
Aim: Reduction mammaplasty is a commonly performed procedure for the treatment of symptomatic
macromastia and is increasingly desired by the obese population. With the increasing prevalence obesity
in the population, it is imperative to understand its effect on postoperative outcomes. The purpose of
this study is to evaluate obesity as an independent risk factor for postoperative complications in breast
reduction surgery using 1:1 patient matching through propensity scores between obese patients and non-
obese controls. Methods: Between 2005 and 2013, the National Surgical Quality Improvement Program
dataset identified a total of 6,016 patients as having undergone primary reduction mammaplasty with
30-day postoperative follow-up. Patients were divided into obese [body mass index (BMI) of 30 or more]
vs. not obese (BMI below 30). Patients were initially analyzed using standard multivariable analysis.
Using propensity scores obtained from a logistic regression model, patients were subsequently matched
1:1 according to preoperative and operative variables to truly isolate the effect of obesity on surgical
outcomes. Outcomes were compared between the matched cohorts using McNemar’s test and the
Wilcoxon signed rank test. Results: In unmatched multivariable analysis, rates of overall complications
(7.2% vs. 5.3%, P = 0.0024), wound complications (5.5% vs. 3.6%, P = 0.0004), superficial surgical site
infection (4.1% vs. 2.8%, P = 0.0050), and wound dehiscence (0.3% vs. 1.1%, P = 0.0005) were found to be
statistically different between obese vs. non-obese, respectively. However, when comparing 1:1 matched
obese and non-obese patients, only wound complications (4.6% vs. 3.1%, P = 0.0334) were significantly
increased in the obese cohort. Conclusion: Using the most robust statistical tools available, obesity was

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http://www.parjournal.net
How to cite this article: Goggin JD, Wong S, Pruszynski JE,
Ver Halen JP. A propensity score matched analysis of obesity as an
independent risk factor for postoperative complications in reduction
DOI: mammaplasty. Plast Aesthet Res 2016;3:259-68.
10.20517/2347-9264.2016.50
Received: 05-07-2016; Accepted: 08-07-2016
© 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc. 259