Top

European Journal of Plastic Surgery

Published in:

06-09-2022 | Breast Reduction Plastic | Original Paper

Residents as primary surgeons do not affect the complication rate in reduction mammaplasties and mastopexies—a 10-year single-center experience

Authors: Elena V. Scharner, Faik Muslic, Evi M. Morandi, Christoph Tasch, Gerhard Pierer, Gabriel Djedovic

Published in: European Journal of Plastic Surgery | Issue 2/2023

Abstract

Background

Reduction mammaplasty and mastopexy are an ideal teaching opportunity for residents. While residents benefit from teaching operations, it is essential to evaluate whether this poses risks for the patient. The purpose of this study is to determine the impact of hands-on training for residents as primary surgeons in reduction mammaplasties and mastopexies.

Methods

The data of 1103 patients who underwent surgery between January 2000 and December 2010 at Innsbruck Medical University were extracted and analyzed by training status of the primary surgeon.

Results

A total of 833 patients were included in the study. The overall complication rate was 4.9%. For surgeries conducted by specialists, the rate was 4.8% and for those performed by residents 5.1% (p = 0.85). No significant difference in complication rates between senior residents and junior residents was found (p = 0.58). Analysis for major and minor complications demonstrated no statistically significant difference between specialists or residents (p = 0.054). A three-way comparison between specialists, senior and junior residents showed significantly more major complications occurring in the junior resident cohort (p = 0.018).

Conclusions

This study demonstrates that having a resident under supervision as a primary surgeon does not increase the complication rate, establishing hands-on residents’ training in plastic surgery as a safe training method.

Level of evidence: Level III, Risk/Prognostic.

Surgeons ASoP. Plastic surgery statistics report 2019 2019 [Available from: https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-full-report-2019.pdf.

Foreman KB, Dibble LE, Droge J, Carson R, Rockwell WB (2009) The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia. Plast Reconstr Surg 124(5):1393–1399CrossRefPubMed

Mello AA, Domingos NA, Miyazaki MC (2010) Improvement in quality of life and self-esteem after breast reduction surgery. Aesthetic Plast Surg 34(1):59–64CrossRefPubMed

Singh KA, Pinell XA, Losken A (2010) Is reduction mammaplasty a stimulus for weight loss and improved quality of life? Ann Plast Surg 64(5):585–587CrossRefPubMed

van der Beek ES, Te Riele W, Specken TF, Boerma D, van Ramshorst B (2010) The impact of reconstructive procedures following bariatric surgery on patient well-being and quality of life. Obes Surg 20(1):36–41CrossRefPubMed

Coriddi M, Koltz PF, Gusenoff JA (2011) Reduction mammaplasty, obesity, and massive weight loss: temporal relationships of satisfaction with breast contour. Plast Reconstr Surg 128(3):643–650CrossRefPubMed

Lewin R, Göransson M, Elander A, Thorarinsson A, Lundberg J, Lidén M (2014) Risk factors for complications after breast reduction surgery. J Plast Surg Hand Surg 48(1):10–14CrossRefPubMed

Nelson JA, Fischer JP, Chung CU, West A, Tuggle CT, Serletti JM et al (2014) Obesity and early complications following reduction mammaplasty: an analysis of 4545 patients from the 2005–2011 NSQIP datasets. J Plast Surg Hand Surg 48(5):334–339CrossRefPubMed

Srinivasaiah N, Iwuchukwu OC, Stanley PR, Hart NB, Platt AJ, Drew PJ (2014) Risk factors for complications following breast reduction: results from a randomized control trial. Breast J 20(3):274–278CrossRefPubMed

10.

Jordan SW, Mioton LM, Smetona J, Aggarwal A, Wang E, Dumanian GA et al (2013) Resident involvement and plastic surgery outcomes: an analysis of 10,356 patients from the American College of Surgeons National Surgical Quality Improvement Program database. Plast Reconstr Surg 131(4):763–773CrossRefPubMed

11.

Fischer JP, Cleveland EC, Shang EK, Nelson JA, Serletti JM (2014) Complications following reduction mammaplasty: a review of 3538 cases from the 2005–2010 NSQIP data sets. Aesthet Surg J 34(1):66–73CrossRefPubMed

12.

Patel SP, Gauger PG, Brown DL, Englesbe MJ, Cederna PS (2010) Resident participation does not affect surgical outcomes, despite introduction of new techniques. J Am Coll Surg 211(4):540–545CrossRefPubMed

13.

Malyar M, Peymani A, Johnson AR, Chen AD, Van Der Hulst R, Lin SJ (2019) The impact of resident postgraduate year involvement in body-contouring and breast reduction procedures: a comprehensive analysis of 9638 patients. Ann Plast Surg 82(3):310–315CrossRefPubMed

14.

Wojcik BM, Lee JM, Peponis T, Amari N, Mendoza AE, Rosenthal MG et al (2018) Do not blame the resident: the impact of surgeon and surgical trainee experience on the occurrence of intraoperative adverse events (iAEs) in abdominal surgery. J Surg Educ 75(6):e156–e167CrossRefPubMed

15.

Aibel K, Blau J, Atia A, Hein R, Hollenbeck ST (2016) The impact of resident participation on surgical efficiency and outcomes in plastic surgery. American Association of Plastic Surgeons 2016 annual meeting 2016.

16.

Jubbal KT, Echo A, Spiegel AJ, Izaddoost SA (2017) The impact of resident involvement in breast reconstruction surgery outcomes by modality: An analysis of 4,500 cases. Microsurgery 37(7):800–807CrossRefPubMed

17.

Sebai ME, Bello RJ, Lifchez SD, Cooney DS, Rosson GD, Cooney CM (2017) The effect of resident involvement on postoperative short-term surgical outcomes in immediate breast reconstruction: a national surgical quality improvement program study of 24,005 patients. Plast Reconstr Surg 139(6):1325–1334CrossRefPubMed

18.

Chatterjee A, Pyfer B, Chen L, Czerniecki B, Tchou J, Fisher C (2015) Resident and fellow participation in breast surgery: an American College of Surgeons NSQIP clinical outcomes analysis. J Am Coll Surg 221(5):988–994CrossRefPubMed

19.

Klement KA, Hijjawi JB, Neuner J, Kelley K, Kong AL (2019) Discussion of preoperative mammography in women undergoing reduction mammaplasty. Breast J 25(3):439–443CrossRefPubMed

Title: Residents as primary surgeons do not affect the complication rate in reduction mammaplasties and mastopexies—a 10-year single-center experience
Authors: Elena V. Scharner
Faik Muslic
Evi M. Morandi
Christoph Tasch
Gerhard Pierer
Gabriel Djedovic
Publication date: 06-09-2022
Publisher: Springer Berlin Heidelberg
Keywords: Breast Reduction Plastic
Mastopexy
Breast Reduction Plastic
Mastopexy
Breast Reduction Plastic
Mastopexy
Published in: European Journal of Plastic Surgery / Issue 2/2023
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI: https://doi.org/10.1007/s00238-022-01994-7

At a glance: The STEP trials

Springer Medicine

Residents as primary surgeons do not affect the complication rate in reduction mammaplasties and mastopexies—a 10-year single-center experience

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2023

Evaluating the effect of detection modalities in the Danish clinical follow-up program of cutaneous melanoma—a retrospective cohort study

Wound complications following reduction mammaplasty: which patients are at risk and what can we do about it? A systematic review

Commentary on “Delayed prosthetic seroma: a localized inflammatory response to COVID vaccination and infection? by Chan SL, Hsieh MKH, Mok JWL & Kong TY”

Autologous reconstruction for partial mastectomy defects: outcomes of latissimus versus abdominal flaps

Transversus abdominus plane blocks do not reduce rates of postoperative prolonged opioid use following abdominally based autologous breast reconstruction: a nationwide longitudinal analysis

Patterns and trends of firework-related adult burns in New South Wales, Australia