A 20-year hospital cohort compared breast reduction procedures performed by plastic surgeons and appropriately trained general surgeons. The findings should not be interpreted as proof of equivalence.
A new breast reduction complications study involving 1,716 patients found nearly identical overall postoperative complication rates in two surgeon groups at a Finnish hospital. The retrospective analysis compared operations performed by plastic surgeons with those performed by general surgeons who had relevant procedural training.
How was the study conducted?
Researchers reviewed consecutive bilateral breast reduction procedures performed between 2005 and 2024 at a single centre. Of the 1,716 patients, 1,335 were treated in the plastic-surgeon group and 381 in the general-surgeon group. The investigators examined patient characteristics, operating time, blood loss, postoperative complications and revision procedures.
The average breast reduction patient age was similar between groups, although there were small differences in body mass index. As this was not a randomized study, the two groups may have differed in factors that are difficult to measure or fully adjust for.
What did the results show?
Overall postoperative complications were reported in 15.4% of patients in the plastic-surgeon group and 15.2% in the general-surgeon group. That difference was not statistically significant in this cohort.
Other outcomes were not identical. Average operating time was longer in the plastic-surgeon group, at 130.4 minutes compared with 112.2 minutes. Average intraoperative blood loss was higher in the general-surgeon group, at 300.9 mL versus 279.0 mL. Wound dehiscence, meaning separation of a healing wound, was reported more frequently in the plastic-surgeon group: 7.5% compared with 2.1%.
These figures describe observed outcomes in one healthcare setting. They do not identify the cause of the differences.
Does this mean surgical training does not matter?
No. The study should not be read as a general comparison of all plastic surgeons with all general surgeons. In the Finnish setting studied, some general surgeons were trained to perform reduction mammoplasty. Local referral patterns, case complexity, experience, operative technique and postoperative care could influence results.
The authors themselves note residual confounding and call for larger prospective research before the findings are generalized to other hospitals or countries.
Why is the finding useful?
Breast reduction can improve physical symptoms and quality of life for appropriately selected patients, but complications and recovery remain important considerations. The study offers a useful benchmark for surgical audit and training discussions.
For patients, the central questions remain the individual surgeon’s qualifications and experience, the hospital’s standards, a clear explanation of risks and a plan for follow-up care. Similar aggregate complication rates in one retrospective study do not replace individualized informed consent or prove that different training pathways are interchangeable.
A key distinction is between an absence of a statistically significant difference and formal evidence that two approaches are equivalent. An equivalence study requires a prespecified margin and a design capable of testing that claim. The Finnish retrospective analysis did not provide that kind of proof. Its findings are best understood as descriptive evidence from one trained surgical workforce.
Original source: Saltvig I, Giordano S. Comparative outcomes and safety of reduction mammoplasty performed by plastic and general surgeons: a 20-year retrospective cohort study of 1716 patients. Updates in Surgery. Published 30 October 2026. Open original source
DOI: 10.1007/s13304-026-02926-x
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