Morrison Kerry A, Vernon Rebecca, Choi Mihye, Karp Nolan S
From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.
Plast Reconstr Surg. 2023 Mar 1;151(3):376e-383e. doi: 10.1097/PRS.0000000000009905. Epub 2022 Nov 19.
Reduction mammaplasty is a safe, effective procedure to alleviate symptoms of adolescent macromastia. However, there remain limited data on surgical complications associated with reduction mammaplasty in adolescents, which may not be concordant with those cited for adults seeking reduction mammaplasty.
A retrospective review was conducted of all consecutively performed reduction mammaplasty cases for symptomatic macromastia in patients aged 20 years and younger over a 7-year period from 2014 to 2021.
One hundred sixty total breasts were analyzed in 80 patients. Mean age was 18.3 ± 1.4 years, with an age range from 15 to 20 years. Mean body mass index was 27.17 ± 5.49 kg/m 2 . Mean reduction weight was 584.79 ± 261.19 g. A medial pedicle was used in 91%, and an inferior pedicle was used in 9%. For skin incision, a Wise pattern was used in 60%, and a short-scar was used in 40%. There was a 16.3% rate of any surgical complication, which included wound healing by secondary intention treated with local wound care. There were no significant risk factors for a surgical complication in reduction mammaplasty, and no differences in surgical complications related to skin incision type, pedicle use, or breast reduction weight. Performance of a receiver operating characteristic curve for age at surgery and complication demonstrated that there was no age cutoff where the risk of surgical complication was appreciably increased or decreased.
Age was not identified as a risk factor for surgical complications in adolescent reduction mammaplasty. Overall, complication rates were very low and minor in nature for adolescent reduction mammaplasty, with no significant risk factors identified.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
缩乳术是一种安全、有效的缓解青少年巨乳症症状的手术。然而，关于青少年缩乳术相关手术并发症的数据仍然有限，这些数据可能与寻求缩乳术的成年人的数据不一致。
对2014年至2021年7年间20岁及以下有症状巨乳症患者连续进行的所有缩乳术病例进行回顾性分析。
对80例患者的160侧乳房进行了分析。平均年龄为18.3±1.4岁，年龄范围为15至20岁。平均体重指数为27.17±5.49kg/m²。91%使用内侧蒂，9%使用下蒂。对于皮肤切口，60%采用Wise模式，40%采用短瘢痕模式。任何手术并发症的发生率为16.3%，其中包括通过局部伤口护理二期愈合的伤口。缩乳术中没有显著的手术并发症风险因素，与皮肤切口类型、蒂的使用或乳房缩小重量相关的手术并发症没有差异。对手术年龄和并发症进行受试者操作特征曲线分析表明，不存在手术并发症风险明显增加或降低的年龄临界值。
年龄未被确定为青少年缩乳术手术并发症的风险因素。总体而言，青少年缩乳术的并发症发生率非常低且性质轻微，未发现显著的风险因素。
临床问题/证据水平：风险，III级
