Zhang Lingya, Zheng Jinlong, Mu Jingpeng, Gao Yunqian, Li Gehong
Department of Nosocomial Infection Control, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
Department of Medical Record, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
Aesthetic Plast Surg. 2022 Dec;46(6):2629-2639. doi: 10.1007/s00266-022-03030-2. Epub 2022 Aug 3.
The popularity of aesthetic breast surgery in China results in greater demand for assessing risk factors for complications and mortality.
To determine the incidence and independent risk factors for postoperative complications following aesthetic breast surgery in China.
A retrospective cohort study on 4973 patients who had aesthetic breast surgery between 2012 and 2021 was performed. Postoperative complications include minor complications (incision healing impaired, hematoma, or fat liquefaction) and surgical site infection (SSI), which were recorded within 30 days after surgery. The follow-up time was expanded to 1 year only after prosthesis implantation procedures. Potential risk factors including age, weight, length of hospital stay, operation time, volume resection, incision location, and other clinical profile information were evaluated.
Among 4973 patients who underwent aesthetic breast surgery, the minor complication rate was 0.54%, and SSI was 0.68%. Augmentation with prosthesis implantation had the highest SSI rate (4.23%), which was significantly associated with increasing age (relative risk [RR] 1.12; P < 0.01) and periareolar incision (RR 5.87, P < 0.01). After augmentation with autologous fat transplantation, postoperative antibiotic use (RR 6.65, P < 0.01) was an independent risk factor for SSI. After adjusting for weight, volume resection over 1500 g (RR 14.7, P < 0.01) was an independent risk factor for SSI of reduction-mastopexy surgery. The complication rate of reduction mammaplasty (1.01%) and gynecomastia correction was lower (0.75%), and there was no record of complication in mastopexy procedures (n = 161).
The incidence of postoperative complications following aesthetic breast surgery is low. Risk factors for complications mainly include increasing age, perioperative antibiotic use, periareolar incision, and extensive volume resection. Much more attention should be focused on those high-risk patients in clinical practice to decrease breast infection.
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中国美容乳房手术的普及导致对评估并发症和死亡率风险因素的需求增加。
确定中国美容乳房手术后术后并发症的发生率及独立风险因素。
对2012年至2021年间接受美容乳房手术的4973例患者进行回顾性队列研究。术后并发症包括轻微并发症（切口愈合不良、血肿或脂肪液化）和手术部位感染（SSI），在术后30天内记录。仅在假体植入手术后，随访时间延长至1年。评估了包括年龄、体重、住院时间、手术时间、切除量、切口位置及其他临床特征信息等潜在风险因素。
在4973例接受美容乳房手术的患者中，轻微并发症发生率为0.54%，SSI发生率为0.68%。假体植入隆乳术的SSI发生率最高（4.23%），这与年龄增长（相对风险[RR]1.12；P＜0.01）和乳晕周围切口（RR 5.87，P＜0.01）显著相关。自体脂肪移植隆乳术后，术后使用抗生素（RR 6.65，P＜0.01）是SSI的独立风险因素。在调整体重后，切除量超过1500 g（RR 14.7，P＜0.01）是缩乳术SSI的独立风险因素。缩乳术（1.01%）和男性乳房肥大矫正术的并发症发生率较低（0.75%），乳房上提术（n = 161）无并发症记录。
美容乳房手术后术后并发症发生率较低。并发症的风险因素主要包括年龄增长、围手术期使用抗生素、乳晕周围切口和广泛的切除量。临床实践中应更加关注那些高危患者，以减少乳房感染。
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