BackgroundReduction mammaplasty improves quality of life by providing both functional and aesthetic benefits for women with macromastia. This study contributes to existing literature on socioeconomic and clinical barriers to referral for plastic surgery procedures, focusing specifically on reduction mammaplasty. MethodsPatients with macromastia were identified via chart review in a single institution from 2021-2022. The treatment pathway for each patient was characterized by reception of referral, completion of plastic surgery consultation, and eventual reception of surgery. Controlling for clinical covariates, multivariate logistic regression was applied to quantify the independent impact of race, insurance, and language status on completion of surgery (p<0.05). ResultsThe final patient cohort included 425 women with macromastia. Of 151 patients who were first seen by a primary care physician, 64 (42%) completed an initial plastic surgery consultation. Among all patients, 160 (38%) eventually underwent reduction mammaplasty. In multivariate regression, current smoking history (OR: 0.08, 95% CI: 0.01-0.59) and higher BMI (OR: 0.94, 95% CI: 0.90-0.97) predicted lower likelihood of completing breast reduction surgery (p<0.05). Minority race and ethnicity, private insurance status, and primary language status were not significant predictor variables of this outcome (p>0.05). ConclusionsIn this study, socioeconomic variables were not independent predictors of completion of breast reduction surgery. However, the association of minority race and ethnicity and non-private insurance status with the most common reasons for breast reduction deferral suggest an indirect influence of socioeconomic status on the treatment pathway.