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National Trends in Reduction Mammaplasty: 72,685 Cases Reveal Dramatic Growth in Pediatric Surgical Volume with Age-Based Perioperative Differences
Rachel Schafer
*, Avi Lamba, Kristina M. Chang, Sara Neimanis
Division of Plastic Surgery, University of Rochester, Rochester, NY
Background: Reduction mammaplasty is performed across both adult and pediatric populations, yet direct comparisons of perioperative outcomes between these groups remain limited. Understanding between these populations is critical for benchmarking care and guiding quality improvement.
Methods: We conducted a retrospective analysis of NSQIP and PNSQIP data from 2012-2024, including 72,685 cases (68,366 adults; 4,319 pediatric patients). Demographic, surgical, and thirty-day outcomes data were analyzed in this study. Temporal trends were analyzed using linear regression stratified by age group, and adult-pediatric comparisons were performed using chi-squared or Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables.
Results: From 2012 to 2024, adult reduction mammaplasty cases increased by approximately 148%, whereas pediatric cases experienced an unprecedented surge of ~1351%, representing more than a tenfold relative growth. Overall case volume rose significantly, with an average of 334 additional adult cases per year (p < 0.001) and 64 additional pediatric cases per year (p < 0.001). Pediatric patients were more frequently Black (31% vs. 21%) and exhibited a lower prevalence of diabetes (3.0% vs. 5.4%). Median operative time was longer in pediatric cases (166 vs. 143 minutes; p < 0.001). Thirty-day complications occurred in 9.9% of cases overall, with adults experiencing higher rates than pediatric patients (10% vs. 4.7%; p < 0.001).
Conclusions: This study represents the largest comparative analysis of adult and pediatric reduction mammaplasty to date and highlights an extraordinary growth in pediatric cases, outpacing adult trends by nearly tenfold. Pediatric patients demonstrate lower comorbidity burdens, longer operative times, and substantially lower complication rates, emphasizing key clinical distinctions relevant to perioperative planning and resource allocation. This study underscores a shifting landscape in surgical demand and reinforces the need for evidence-based guidelines tailored to this population.
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