The Association Between Obesity, Obstructive Sleep Apnea, and Postoperative Complications in Breast Reduction Patients: A Propensity Score-Matched Analysis.

[BACKGROUND] Obstructive sleep apnea (OSA) is associated with increased risk for several comorbidities, with the most prominent being obesity. Obesity is strongly linked to the development of macromastia, a primary indication for breast reduction. It is highly important to assess whether OSA serves as an independent risk factor for postoperative complications.

[OBJECTIVES] The aim of this study was to assess the rates of short- and long-term complications following breast reduction in obese patients (BMI >30) with and without documented OSA.

[METHODS] A retrospective cohort analysis was conducted using the TriNetX Global Collaborative Network. Patients >18 years, with BMI >30, who underwent breast reduction were divided into 2 groups: those with documented OSA before surgery and those with no history of OSA. Propensity score matching (PSM) was applied to balance demographic and clinical variables. Primary outcomes included short-term postoperative complications at 30, 60, and 90 days. Secondary outcomes included long-term complications after 1 and 2 years.

[RESULTS] After 1:1 PSM, each cohort consisted of 3414 patients. Within 30 days postsurgery, patients in the OSA cohort had a significantly increased risk of surgical-site infection (risk ratio [RR]: 1.444, = .02), readmission (RR: 1.512, = .03), inpatient hospitalization (RR: 1.326, = .04), and opioid use (RR: 1.122, < .0001) compared with the control group. Results remained consistent at 60 and 90 days postsurgery. For long-term outcomes, OSA patients had reduced rates of breast deformity at 1 year and surgical revision rates at 2 years.

[CONCLUSIONS] OSA is associated with increased risk for short-term postoperative complications following breast reduction surgery. However, OSA was paradoxically associated with lower rates of breast deformity and surgical revision.