Myung Yujin, Kwon Heeyeon, Lee Sang Woo, Baek Rong-Min
From the *Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine; and †DA Plastic Surgery Clinic, Seoul, Korea.
Ann Plast Surg. 2017 Apr;78(4):371-378. doi: 10.1097/SAP.0000000000000913.
Each year, thousands of patients, particularly Eastern Asians, receive reduction malarplasty to achieve a more feminine and slender facial appearance. To date, there lacks a systematic analysis regarding the postoperative complications related to this procedure. Hence, the authors performed a comprehensive literature review with meta-analysis.
Articles were searched and reviewed using the MEDLINE and Embase databases. Among the studies regarding surgical outcomes after reduction malarplasty, articles with explicit reports and clear numbers of postoperative complications were selected for meta-analysis. Additionally, manual searches were made from references of selected articles.
A total 14 retrospective review articles that represented 3149 cases were reviewed, and 7 different postoperative complications were analyzed. The complication that showed the highest weighted mean percentage of frequency was transient sensory weakness, with 5.8% (Z = -18.012; 95% confidence interval, 4.3-7.6%), followed by drooping (2.8%), nonunion (2.2%), asymmetry (1.8%), mouth opening restriction (1.8%), uncontrolled bleeding (1.3%), and facial nerve injury (0.9%).
According to our meta-analysis of previous literatures, the aggregated rates of various complications related to reduction malarplasty were not high. Among the various complications, short-term sensory weakness was shown as the most frequent complication, emphasizing the necessity of patient warning and education before and after the operation. Moreover, soft tissue drooping and bone nonunion are also not rare and surgeons should be aware of these complications.
每年，数以千计的患者，尤其是东亚患者，接受颧骨缩小整形手术以获得更具女性化和纤细的面部外观。迄今为止，缺乏关于该手术术后并发症的系统分析。因此，作者进行了一项综合文献回顾并进行荟萃分析。
使用MEDLINE和Embase数据库检索和回顾文章。在关于颧骨缩小整形术后手术结果的研究中，选择有明确报告和术后并发症明确数量的文章进行荟萃分析。此外，从所选文章的参考文献中进行人工检索。
共回顾了14篇代表3149例病例的回顾性文章，并分析了7种不同的术后并发症。出现频率加权平均百分比最高的并发症是短暂性感觉无力，为5.8%（Z = -18.012；95%置信区间，4.3 - 7.6%），其次是下垂（2.8%）、骨不连（2.2%）、不对称（1.8%）、张口受限（1.8%）、出血失控（1.3%）和面神经损伤（0.9%）。
根据我们对既往文献的荟萃分析，与颧骨缩小整形相关的各种并发症的总体发生率并不高。在各种并发症中，短期感觉无力是最常见的并发症，强调了手术前后对患者进行警示和教育的必要性。此外，软组织下垂和骨不连也并不罕见，外科医生应了解这些并发症。
