Ogunleye Adeyemi A, Leroux Ofelia, Morrison Norman, Preminger Aviva B
From the *Division of Plastic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC; and † Division of Plastic Surgery, Department of Surgery, Columbia University Medical Center/Harlem Hospital, New York, NY.
Ann Plast Surg. 2017 Jul;79(1):13-16. doi: 10.1097/SAP.0000000000001059.
Reduction mammaplasty is a commonly-performed procedure among plastic surgeons. Although several methods exist, the Wise pattern/inferior pedicle (IP) technique is the most widely used. The vertical scar/superomedial pedicle (SP) technique has gained acceptance for its shorter scar and more durable projection results, but some hesitation remains with its use in larger volume reductions.The incidence of complications in 124 consecutively performed breast reductions (246 breasts) at a single institution using either the Wise pattern/IP technique or vertical scar/SP technique, as well as risk factors associated with them, was determined. Patient demographics, comorbidities, intraoperative details, and major and minor complications were assessed.Ninety (72.6%) patients underwent SP, and 39 patients had IP reductions. Minor infections and wound dehiscence were the most common complications (11 each [8.9%]), followed by minor nonoperative hematomas, 10 (8.1%) and fat necrosis, 7 (5.6%). The mean weight of resected tissue per breast was 692 g. No nipple loss, major complications or reexplorations occurred. Obese, diabetic patients were more likely to undergo IP compared with SP reductions. After adjustment in a multivariate analysis, there was no significant difference in complication rates between the 2 methods (IP vs SP: odds ratio, 2.65; 95% confidence interval, 0.85-8.27; P = 0.09). The results were similar after the analysis was restricted to patients with mean weight of resected tissue per breast greater than 1000 g.There was no significant difference in complications between IP and SP reduction, suggesting that the SP method is a safe alternative to the IP technique, even in macromastia patients undergoing large-volume reductions.
缩乳术是整形外科医生常做的手术。虽然存在多种方法，但 Wise 模式/下蒂（IP）技术是使用最广泛的。垂直瘢痕/上内侧蒂（SP）技术因其瘢痕较短且隆乳效果更持久而被认可，但在进行较大体积的缩乳时，其应用仍存在一些犹豫。我们确定了在单一机构连续进行的 124 例乳房缩小术（246 个乳房）中使用 Wise 模式/IP 技术或垂直瘢痕/SP 技术的并发症发生率，以及与之相关的危险因素。评估了患者的人口统计学特征、合并症、术中细节以及主要和次要并发症。90 例（72.6%）患者接受了 SP 技术，39 例患者采用了 IP 技术缩乳。轻微感染和伤口裂开是最常见的并发症（各 11 例[8.9%]），其次是轻微的非手术性血肿，10 例（8.1%）和脂肪坏死，7 例（5.6%）。每侧乳房切除组织的平均重量为 692 g。未发生乳头丢失、重大并发症或再次手术。与采用 SP 技术缩乳相比，肥胖、糖尿病患者更有可能采用 IP 技术。在多变量分析进行调整后，两种方法的并发症发生率没有显著差异（IP 与 SP：优势比，2.65；95%置信区间，0.85 - 8.27；P = 0.09）。在将分析限制于每侧乳房切除组织平均重量大于 1000 g 的患者后，结果相似。IP 技术和 SP 技术缩乳的并发症没有显著差异，这表明 SP 方法是 IP 技术的一种安全替代方法，即使在进行大体积缩乳的巨乳症患者中也是如此。
