From the Mãe de Deus Health System Porto Alegre; Divisions of Plastic Surgery and Services Research, University of Utah; Departments of Surgery and Biomedical Engineering, and Division of Plastic Surgery, University of Alabama at Birmingham; University of Chicago; University of Illinois at Chicago; University of Pittsburgh School of Medicine; Cooper University Hospital; Graduate Program in Medicine and Health Sciences, School of Medicine, Pontifical University Catholic RS; Jawaharlal Institute of Postgraduate Medical Education & Research; Department of Surgery, Joan C. Edwards College of Medicine, Marshall University; University of Missouri-Kansas City School of Medicine; and University of Kansas School of Medicine.
Plast Reconstr Surg. 2021 Nov 1;148(5):1014-1019. doi: 10.1097/PRS.0000000000008217.
Enhanced understanding of early postoperative adverse events will improve patient counseling and preoperative risk modification to decrease complications in implant-based breast augmentation. This study seeks to evaluate the early major adverse events following cosmetic breast augmentation.
A retrospective cohort analysis of the Tracking Outcomes and Operations for Plastic Surgeons database was performed to identify any women undergoing augmentation mammaplasty with an implant between 2008 and 2016.
A total of 84,296 patients were studied. Major adverse events were identified in 0.37 percent. Seroma requiring drainage was observed in 0.08 percent, hematoma requiring drainage was observed in 0.15 percent, deep wound disruption was observed in 0.09 percent, and implant loss was observed in 0.11 percent. The authors identified multiple independent predictors of major adverse events, including body mass index greater than 30 kg/m2 (relative risk, 2.05; p < 0.001), tobacco use (relative risk, 2.25; p < 0.001), and diabetes mellitus (relative risk, 1.8; p < 0.05). Use of a periareolar incision significantly increased the risk of developing an early postoperative complication (relative risk, 1.77; p < 0.001).
The findings of this study indicate an early major adverse event rate following cosmetic breast augmentation with implants of 0.37 percent. The authors identified multiple independent predictors of major adverse events, including body mass index greater than 30 kg/m2, tobacco use, and diabetes mellitus. In addition, when controlling for other factors, periareolar incision significantly increased the risk for major adverse events, when compared to an inframammary incision.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
深入了解术后早期不良事件将有助于改善患者咨询和术前风险修正，以减少植入式乳房增大术的并发症。本研究旨在评估美容乳房增大术后的早期主要不良事件。
对整形医师跟踪结果和操作数据库进行回顾性队列分析，以确定 2008 年至 2016 年间任何接受植入物乳房增大术的女性。
共研究了 84296 名患者。 0.37%的患者发生了主要不良事件。 0.08%的患者发生了需要引流的血清肿，0.15%的患者发生了需要引流的血肿，0.09%的患者发生了深部伤口破裂，0.11%的患者发生了植入物丢失。作者确定了多个独立的主要不良事件预测因素，包括体重指数大于 30kg/m2（相对风险，2.05；p<0.001）、吸烟（相对风险，2.25；p<0.001）和糖尿病（相对风险，1.8；p<0.05）。乳晕切口的使用显著增加了术后早期并发症的风险（相对风险，1.77；p<0.001）。
本研究结果表明，植入物美容乳房增大术后早期主要不良事件发生率为 0.37%。作者确定了多个独立的主要不良事件预测因素，包括体重指数大于 30kg/m2、吸烟和糖尿病。此外，当控制其他因素时，乳晕切口与经乳晕下切口相比，显著增加了主要不良事件的风险。
临床问题/证据水平：治疗性，III 级。
