Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
Wuhan Clinical Research Center for Superficial Organ Reconstruction, Wuhan, 430022, China.
Aesthetic Plast Surg. 2021 Aug;45(4):1385-1396. doi: 10.1007/s00266-021-02167-w. Epub 2021 Mar 1.
Women with macromastia experienced constitutional and psychosocial symptoms which could be improved by vertical scar or Inverted-T scar reduction mammaplasty. The authors conducted the first systematic review and meta-analysis in an attempt to declare the differences of the vertical scar versus the Inverted-T scar reduction technique by comparing the postoperative complications and aesthetic effects.
PubMed, EMBASE, Web of Science, Scopus and Cochrane Central Register of Controlled Trials databases for clinical studies were searched through June 30, 2019. Cumulative analysis was conducted using the Review Manager Version 5.3 software. The summary odds ratio (OR) was estimated using random effect models at 95% confidence intervals (CIs), statistical heterogeneity was tested using the Chi-square test and risk of bias was assessed using the Cochrane Handbook 5.1.0 and the Newcastle-Ottawa scale (NOS).
Two randomized controlled trials (RCT) and nine observational comparative studies were included. The vertical scar method was significantly lower than the Inverted-T scar method in overall incidence of complications (OR: 2.06; 95%CI, 1.15 to 3.70; P: 0.002) and wound dehiscence (OR: 4.62; 95%CI, 2.33 to 9.16; P<0.00001). No significant differences in seroma, hematoma, nipple necrosis, fat necrosis and reoperation were noted.
Both two breast reduction techniques are equally safe, while the vertical scar approach resulted in a statistically lower rate of overall complications and wound dehiscence.
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巨乳症女性存在体质和心理社会症状，可通过垂直瘢痕或倒置 T 形瘢痕缩小乳房成形术改善。作者进行了首次系统评价和荟萃分析，试图通过比较术后并发症和美学效果，阐明垂直瘢痕与倒置 T 形瘢痕缩小技术的差异。
检索 2019 年 6 月 30 日前PubMed、EMBASE、Web of Science、Scopus 和 Cochrane 对照试验中心注册数据库中的临床研究。使用 Review Manager Version 5.3 软件进行累积分析。使用随机效应模型估计汇总比值比（OR），置信区间（CI）为 95%，使用 Chi-square 检验测试统计学异质性，使用 Cochrane 手册 5.1.0 和纽卡斯尔-渥太华量表（NOS）评估偏倚风险。
纳入 2 项随机对照试验（RCT）和 9 项观察性对照研究。垂直瘢痕法的总体并发症发生率（OR：2.06；95%CI，1.15 至 3.70；P=0.002）和伤口裂开（OR：4.62；95%CI，2.33 至 9.16；P<0.00001）显著低于倒置 T 形瘢痕法。血清肿、血肿、乳头坏死、脂肪坏死和再次手术无显著差异。
两种乳房缩小技术均同样安全，而垂直瘢痕法的总体并发症和伤口裂开发生率较低。
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