Wagner Ryan D, Lisiecki Jeffrey L, Chiodo Michael V, Rohrich Rod J
Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, TX, United States.
Dallas Plastic Surgery Institute, Dallas, TX, United States.
JPRAS Open. 2022 May 13;34:1-9. doi: 10.1016/j.jpra.2022.05.003. eCollection 2022 Dec.
Mastopexy and reduction mammaplasty are commonly performed procedures in plastic surgery with many variations in incision pattern, pedicle design, and additional support maneuvers. Aesthetically pleasing on table results are widely accomplished; however, the longevity of the outcome and sustained correction of ptosis or pseudoptosis is not universal. A systematic review of mastopexy and reduction mammaplasty procedures was performed to investigate which techniques provided the greatest long-term correction of ptosis.
A broad search of the literature was performed using the PubMed database from inception to December of 2021. Study characteristics, number of patients, number of breasts, technique, outcome, and average follow-up time were extracted for analysis. Study quality was assessed using the Newcastle-Ottawa Scale when applicable.
The primary search yielded 1123 articles. After two levels of screening, 24 articles were identified for analysis. This included 16 case series, seven cohort studies, and one randomized controlled study. From these studies, 1235 patients and 2235 breasts were analyzed. The majority of articles reported on a change in the nipple to inframammary fold and sternal notch to nipple distances.
In the analytical studies, superior and superomedial pedicles tended to provide greater long-term stability than inferior pedicles. Mesh, dermal suspension flaps, and muscular slings showed promise in providing additional support over standard techniques. No single procedure is ideal for all patients; however, this systematic review provides a valuable description of techniques and long-term outcomes to guide surgical planning.
乳房上提术和乳房缩小术是整形外科中常见的手术，在切口模式、蒂部设计和额外的支撑操作方面有多种变化。术中获得美观的效果很常见；然而，手术效果的持久性以及对乳房下垂或假性下垂的持续矫正并非普遍现象。对乳房上提术和乳房缩小术进行了系统评价，以研究哪些技术能提供最大程度的长期下垂矫正效果。
使用PubMed数据库对从建库至2021年12月的文献进行广泛检索。提取研究特征、患者数量、乳房数量、技术、结果和平均随访时间进行分析。适用时使用纽卡斯尔-渥太华量表评估研究质量。
初步检索得到1123篇文章。经过两级筛选，确定24篇文章进行分析。其中包括16个病例系列、7个队列研究和1个随机对照研究。对这些研究中的1235例患者和2235个乳房进行了分析。大多数文章报告了乳头至乳房下皱襞以及胸骨切迹至乳头距离的变化。
在分析性研究中，上蒂和上内侧蒂比下蒂往往能提供更大的长期稳定性。网片、真皮悬吊皮瓣和肌肉吊带在提供比标准技术更多的支撑方面显示出前景。没有一种单一的手术方法对所有患者都是理想的；然而，本系统评价提供了关于技术和长期结果的有价值描述，以指导手术规划。
