Derby Brian M, Grotting James C, Redden David T
Dr Derby is a plastic surgeon in private practice in Sarasota, FL. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL; a Clinical Professor, Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI; and is the CME/MOC Section Editor for Aesthetic Surgery Journal. Dr Redden is the Chair, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL.
Aesthet Surg J. 2016 Apr;36(4):417-30. doi: 10.1093/asj/sjv217. Epub 2016 Feb 23.
The senior author (JCG) has described the vertical sculpted pillar breast reduction.
This manuscript aimed to compare this technique's safety profile to other established techniques via complication rate reporting. Few studies have utilized the BREAST-Q for long-term outcomes reporting in bilateral reduction mammaplasty patients. BREAST-Q outcome comparisons, between cosmetic and insurance-based breast reduction cohorts, have not been previously reported.
A retrospective chart review was performed on patients who underwent reduction mammaplasty using the vertical sculpted pillar technique. The BREAST-Q postoperative reduction mammaplasty module was administered. Complication rates and outcomes data were compared among patient cohorts distinguished by pedicle, scar pattern, and payor population. Statistically significant differences were set at P < .05.
Compared to the superior pedicle, use of the superomedial pedicle statistically increased rates of postoperative fat necrosis in this series. Complication rates did not differ among scar patterns, but use of a J, L-shaped, or short-T scar decreased the need for secondary/revisional surgery. Cosmetic and insurance-based outcomes did not differ in any domain of the postoperative reduction mammaplasty BREAST-Q module.
Complications data for the vertical sculpted pillar reduction mammaplasty were comparable to published results for other techniques. Complication rates are unaffected by scar pattern. Superomedial pedicle selection and larger insurance-based reductions may predispose to statistically significant increases in fat necrosis compared to use of the superior pedicle. Payor source neither affects the majority of complication rates, nor BREAST-Q satisfaction and quality of life domains. This information can be used to improve management of expectations during the preoperative consultation process.
4 Therapeutic.
资深作者（JCG）已描述了垂直塑形柱状乳房缩小术。
本手稿旨在通过报告并发症发生率，将该技术的安全性与其他既定技术进行比较。很少有研究使用BREAST-Q对双侧乳房缩小术患者进行长期结果报告。此前尚未报道过基于美容和保险的乳房缩小队列之间的BREAST-Q结果比较。
对采用垂直塑形柱状技术进行乳房缩小术的患者进行回顾性病历审查。使用BREAST-Q术后乳房缩小术模块。比较以蒂、瘢痕模式和付款人群区分的患者队列之间的并发症发生率和结果数据。设定统计学显著性差异为P <.05。
与上蒂相比，在本系列中使用上内侧蒂在统计学上增加了术后脂肪坏死的发生率。瘢痕模式之间的并发症发生率没有差异，但使用J形、L形或短T形瘢痕减少了二次/修复手术的需求。在术后乳房缩小术BREAST-Q模块的任何领域，基于美容和保险的结果没有差异。
垂直塑形柱状乳房缩小术的并发症数据与其他技术的已发表结果相当。并发症发生率不受瘢痕模式影响。与使用上蒂相比，选择上内侧蒂和基于保险的更大范围缩小术可能在统计学上显著增加脂肪坏死的发生率。付款来源既不影响大多数并发症发生率，也不影响BREAST-Q满意度和生活质量领域。这些信息可用于在术前咨询过程中改善对预期的管理。
4级治疗性。
