Division of Plastic and Reconstructive Surgery, Department of Surgical Sciences, School of Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
Department of Plastic and Reconstructive Surgery, Radboud University Hospital, Nijmegen, The Netherlands.
Aesthetic Plast Surg. 2020 Jun;44(3):689-697. doi: 10.1007/s00266-020-01657-7. Epub 2020 Mar 3.
The aim of the study was to describe details of surgical techniques and objectively evaluate nipple-areola (NAC) sensibility and viability of septum-based mammaplasties compared to not septum-based reduction techniques.
Data regarding NAC sensibility for static and moving one- and two-point discrimination were prospectively collected from 63 active group hypertrophic-breasted patients undergoing septum-based reduction mammaplasty preoperatively, at 6 and 12 months postoperatively, and from a control group of 60 patients who underwent not septum-based techniques. Fixed and mixed effect models were used for statistical analysis.
Comparison of complications showed no significant differences between groups (p = 0.07). After adjusting the results of the active group according to type of sensory testing, it emerged that the threshold decreases by 10% (p = 0.0003) at 6 months and even reaches 43% (p < 0.0001) at 12 months. The results have been modulated according to age, since the variation is less marked when age increased, by 0.6% at 6 months and 0.8% at 12 months (p = 0.019). The effects of the BMI can only be seen at 12 months, with an increase by 1.3% per year (p = 0.033). Among septum-based techniques, the inferior-central pedicle showed better sensibility outcomes even if not significantly (p = 0.06). Comparison of NAC sensibility outcomes showed that active group had thresholds that were 48% lower when compared to those of the control group at 12 months postoperatively (p < 0.001).
Septum-based mammaplasty gives optimal results in terms of NAC viability with a significant improvement of sensibility postoperatively. Comparative outcomes on sensibility were also significantly better than not septum-based techniques.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
本研究旨在描述基于隔瓣的乳房缩小术与非隔瓣技术相比的手术技术细节,并客观评估乳头乳晕(NAC)的感觉和活力。
前瞻性收集 63 例活跃组肥大性乳房患者术前、术后 6 个月和 12 个月的 NAC 静态和移动单点和两点辨别觉感觉数据,以及 60 例接受非隔瓣技术的对照组患者数据。使用固定和混合效应模型进行统计分析。
并发症比较两组无显著差异(p=0.07)。根据感觉测试类型调整活跃组结果后,结果显示 6 个月时阈值下降 10%(p=0.0003),甚至在 12 个月时达到 43%(p<0.0001)。结果根据年龄进行了调制,因为当年龄增加时,变化幅度较小,6 个月时为 0.6%,12 个月时为 0.8%(p=0.019)。BMI 的影响仅在 12 个月时可见,每年增加 1.3%(p=0.033)。在隔瓣技术中,下中央蒂显示出更好的感觉结果,尽管差异无统计学意义(p=0.06)。NAC 感觉结果比较显示,活跃组术后 12 个月时的阈值比对照组低 48%(p<0.001)。
基于隔瓣的乳房缩小术在 NAC 活力方面效果最佳,术后感觉明显改善。感觉的对比结果也明显优于非隔瓣技术。
证据水平 II:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266。