Toplu Gaye, Altınel Dinçer, Serin Merdan
Department of Plastic Surgery, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul, Turkey.
Eur J Breast Health. 2021 Mar 31;17(2):157-164. doi: 10.4274/ejbh.galenos.2021.6336. eCollection 2021 Apr.
This study aimed to investigate whether there was an increase in the number of postoperative complications in patients undergoing reduction mammoplasty depending on the technique used (i.e., pedicle type, skin incision pattern), existence of concomitant diseases, and presence of other risk factors.
A total of 186 patients who underwent breast reduction between 2013 and 2018 (bilateral, n = 170; unilateral, n = 16) were included in the study. A retrospective review of the data of patients who underwent reduction mammoplasty, which was performed by the same surgical team in a single institution over a 6-year period, was carried out. Superomedial, superior, and inferior pedicles were used in 99, 55, and 32 patients, respectively. The median follow-up period was 4 years.
The median patient age was 45 (range: 16-75) years. The median total reduction weight was 2,194 (range: 80-4,800) grams. The median distance between the sternal notch and nipple was 31 cm (range: 24-45 cm) for the right breast and 30 cm (range: 22-45 cm) for the left breast. The overall complication rate was 6.9%. The complication rates in patients with and without any concomitant diseases were 10.2% and 4.6%, respectively. The overall complication rate was significantly higher in patients with smoking habit, accessory breasts, progesterone use, cerebrovascular disease, morbid obesity (Body Mass Index ≥40 kg/m), and thalassemia.
Our analysis shows that the presence of concomitant diseases increases the risk for postoperative complications in patients who underwent reduction mammoplasty. Our findings do not suggest that any of the techniques have significant superiority to each other in terms of pedicle safety and overall complication rate.
本研究旨在调查根据所采用的技术（即蒂部类型、皮肤切口模式）、合并疾病的存在情况以及其他风险因素，接受缩乳术的患者术后并发症数量是否会增加。
本研究纳入了2013年至2018年期间接受双侧乳房缩小术的186例患者（双侧，n = 170；单侧，n = 16）。对同一手术团队在单一机构进行的为期6年的缩乳术患者数据进行了回顾性分析。分别有99例、55例和32例患者使用了上内侧蒂、上蒂和下蒂。中位随访期为4年。
患者的中位年龄为45岁（范围：16 - 75岁）。总缩乳重量的中位数为2194克（范围：80 - 4800克）。右乳房胸骨切迹与乳头之间的中位距离为31厘米（范围：24 - 45厘米），左乳房为30厘米（范围：22 - 45厘米）。总体并发症发生率为6.9%。有和没有任何合并疾病的患者并发症发生率分别为10.2%和4.6%。有吸烟习惯、副乳、使用孕酮、患有脑血管疾病、病态肥胖（体重指数≥40 kg/m²）和地中海贫血的患者总体并发症发生率显著更高。
我们的分析表明，合并疾病的存在会增加接受缩乳术患者术后并发症的风险。我们的研究结果并未表明任何一种技术在蒂部安全性和总体并发症发生率方面具有显著优势。
