Does History of Reduction Mammoplasty Predispose to Lactation Complications? A Multicenter Retrospective Cohort.

BACKGROUND: Reduction mammoplasty is a prevalent procedure, primarily done to treat macromastia. While it is known for its positive clinical and quality of life benefits, there are still concerns regarding long-term complications it may carry, especially during pregnancy and lactation. PURPOSE: Our primary objective is to evaluate whether reduction mammoplasty increased the risk for breastfeeding complications compared with matched control patients who did not undergo prior aesthetic breast surgery. METHODS: A retrospective study using TriNetX platform was queried for female patients aged 18 years and older. Patients who underwent reduction mammoplasty and subsequently delivered were compared with patients who delivered without a history of aesthetic breast surgery. The primary outcome were breastfeeding complications within a year after delivery, including lactation disorders, breast infections, mastitis, antibiotic prescriptions, and emergency department (ED) visits. RESULTS: 1103 patients who had reduction mammoplasty and delivery were propensity-matched to 1103 control patients who had delivery. Within 1 year of delivery, patients who had reduction mammoplasty had a comparable risk for disorders of lactations [hazard ratio (HR) = 1.41; CI (0.87-2.27); p = 0.16], infections of breast [HR = 0.67; CI (0.39-1.16); p = 0.15], and mastitis [HR = 0.60; CI (0.31-1.15); p = 0.12]. However, an increased risk for antibiotic prescription [HR = 1.20; CI (1.05-1.37); p = 0.005] and ED visits [HR = 1.38; CI (1.13-1.67); p = 0.0011] were observed. CONCLUSIONS: Reduction mammoplasty was not associated with a significant increase in breastfeeding disorders or breast infections after delivery, but was associated with higher antibiotic prescriptions and ED visits. These findings suggest that the procedure may not be linked to major adverse lactation outcomes. 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 .