Stevens W Grant, Cohen Robert, Schantz Steven A, Stoker David A, Vath Steven D, Hirsch Elliot M, Heck Robert, Freeman Mark E
Aesthet Surg J. 2006 Jul-Aug;26(4):432-9. doi: 10.1016/j.asj.2006.06.006.
Although several studies have been published documenting the safety of laser-assisted breast reduction, they have involved only small numbers of patients.
The authors conducted a retrospective chart review of a series of 367 consecutive patients who underwent inferior pedicle laser-assisted breast reduction surgery at a single outpatient facility from 1995 through 2004.
All patients received appropriate preoperative intravenous antibiotics and had sequential compression devices placed on their lower extremities before induction of anesthesia. Pedicle deepithelialization was performed using a carbon dioxide laser in continuous mode. Following deepithelialization, an inferior pedicle Wise-pattern breast reduction was performed in standard fashion. In approximately 20% of cases, breast reduction was combined with lipoplasty, facial aesthetic surgery, or abdominoplasty. Minor complications assessed included seroma, hematoma, infection, dog-ear, and incisional wound breakdown. Major complications were defined as >25% nipple/areola necrosis, blood transfusion, deep vein thrombosis, pulmonary embolus, myocardial infarction, or death.
No major complications were noted in our series. Two patients with infections required short-term hospitalization for administration of intravenous antibiotics. A total of 47 minor complications occurred in 42 patients (11%), including 36 incisional wound breakdowns, 6 infections, 3 hematomas, 1 seroma, and 1 dog-ear revison. The incisional breakdowns included 25 minor T-zone wounds, 2 nipple-areolar complex wounds, and 9 wounds of the vertical and transverse incisions. No inclusion cysts were noted in any patients.
Complication rates for our series of patients who underwent laser-assisted breast reduction surgery were consistent with those reported for non-laser-assisted procedures. These results, combined with the benefits and efficient operating time afforded by laser deepithelialization, indicate that laser-assisted breast reduction surgery can provide an alternative to standard methods of deepithelialization for those surgeons with access to a carbon dioxide laser.
尽管已有多项研究发表，记录了激光辅助乳房缩小术的安全性，但这些研究仅涉及少数患者。
作者对1995年至2004年期间在一家门诊机构连续接受367例下蒂激光辅助乳房缩小手术的患者进行了回顾性病历审查。
所有患者术前均接受了适当的静脉抗生素治疗，并在麻醉诱导前在下肢放置了序贯加压装置。使用连续模式的二氧化碳激光进行蒂部去上皮化。去上皮化后，以标准方式进行下蒂Wise型乳房缩小术。在大约20%的病例中，乳房缩小术与脂肪成形术、面部美容手术或腹部整形术联合进行。评估的轻微并发症包括血清肿、血肿、感染、“狗耳”畸形和切口裂开。主要并发症定义为乳头/乳晕坏死>25%、输血、深静脉血栓形成、肺栓塞、心肌梗死或死亡。
我们的系列研究中未发现主要并发症。两名感染患者需要短期住院接受静脉抗生素治疗。42例患者（11%）共发生47例轻微并发症，包括36例切口裂开、6例感染、3例血肿、1例血清肿和1例“狗耳”畸形修复。切口裂开包括25例轻微的T区伤口、2例乳头乳晕复合体伤口以及9例垂直和横向切口伤口。所有患者均未发现包涵囊肿。
我们这组接受激光辅助乳房缩小手术患者的并发症发生率与非激光辅助手术报道的发生率一致。这些结果，再加上激光去上皮化带来的益处和高效的手术时间，表明对于有二氧化碳激光设备的外科医生而言，激光辅助乳房缩小手术可以为标准去上皮化方法提供一种替代方案。
