The risks of breast reduction are greater in patients over the age of fifty, reports a study in the December edition of Plastic and Reconstructive Surgery®, the medical journal of the American Society of Plastic Surgeons (ASPS).
The increased complication rate in older women likely reflects age-related changes in hormone levels, according to the new research by ASPS Member Surgeon Michele A. Shermak, MD, and colleagues of The Johns Hopkins Medical Institutions, Baltimore.
The authors evaluated 1,192 cases of women undergoing breast reduction surgery during a ten-year period (1999 to 2009). They assessed rates and types of complications in three different age groups:
- under 40
- 40 to 50
- over 50
Breast reduction, one of the most commonly performed plastic surgery procedures, is highly effective in relieving symptoms related to overlarge breasts, such as back, shoulder and neck pain, posture problems and bra strap compression.
The results suggest that women over 50 are at higher risk of developing an infection after breast reduction surgery. On analysis controlling for other medical conditions, the infection rate was 2.7 times higher for women over 50, compared to the under-40 group.
Women over 50 also tended to have a higher rate of wound healing problems, leading to a higher rate of repeat surgery to remove areas of dead skin, called debridement. These trends were not statistically significant, however.
Women ages 40 to 50 also showed a non-significant trend toward an increased risk of infection. Other important types of complications were unaffected by age.
Risks Could Be Related to Declining Hormone Levels?Previous studies have identified several breast reduction risk factors, including obesity, extensive breast reduction and smoking. However, the new study is the first to focus specifically on age.
The results suggest an increased rate of infections-and possibly other complications-after breast reduction surgery in women over 50. The increased risk is likely related to age-related declines in hormone levels, Dr. Shermak and colleagues believe. This is borne out by the trend toward increased infections among women in their forties, when hormone levels start to decline.
In addition, infections tended to be less common in women who were using hormone replacement therapy. Meanwhile, the infection rate appeared higher in women who had undergone hysterectomy or oophorectomy (removal of the ovaries), which lead to sharp drops in hormone levels.
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