Two Surgeons Are Faster than One: A Comparative Study to Evaluate Efficiency and Outcomes in Reduction Mammaplasty

BACKGROUND: The increasing demand for reduction mammaplasty has heightened the need for cost-effective and efficient surgical practices. Evidence from other surgical fields suggests that co-surgeon teams can improve operative efficiency. AIMS AND OBJECTIVES: This study aimed to compare operative time and outcomes in reduction mammaplasty performed by co-surgeons (CS) versus a single surgeon (SS). MATERIALS AND METHODS: We conducted a retrospective cohort study including all consecutive patients who underwent primary reduction mammaplasty in a 20-years period. All procedures were led by attending faculty surgeons, with assistants being either residents or other attendings. The primary outcome was operative time; secondary outcomes included intraoperative blood loss; resection weight, postoperative complications, reoperations, and length of hospital stay. RESULTS: A total of 1716 patients were included: 855 (49.8%) underwent surgery with a SS, and 861 (50.2%) with a CS. Demographic and comorbidity profiles were mostly similar across the groups. Operative time was significantly shorter in the CS group (119.6 vs. 136.1 minutes, p < 0.001). Postoperative complication rates and early reoperations were similar between groups. However, CS cases had a longer mean hospital stay (0.6 vs. 0.4 days, p < 0.001). Late reoperations (>30 days post-op), particularly for dog-ear corrections were more common in the CS group (11.7 vs. 3.0%, p < 0.001). Multivariate analysis showed that higher BMI and smoking were significant predictors of complication occurrence. CONCLUSION: Using co-surgeons in reduction mammaplasty significantly reduces operative time. However, it may be associated with longer hospital stay and increased long-term reoperation rates. Further studies are needed to evaluate the cost-benefit ratio of this approach. 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 .