Medor Maria C, Bouhadana Gabriel, Churchill Isabella F, Hemmerling Thomas, Bonapace-Potvin Michelle, Papanastasiou Constantine, Mussie Abiye, Borsuk Daniel E, Papanastasiou Vasilios W
Division of Plastic and Reconstructive Surgery, Department of Surgery, Université de Montreal, Montreal, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Plast Reconstr Surg Glob Open. 2023 Mar 8;11(3):e4843. doi: 10.1097/GOX.0000000000004843. eCollection 2023 Mar.
There is no consensus regarding implant size as an independent risk factor for complications in primary breast augmentation. Choosing appropriate implant volume is an integral part of the preoperative planning process. The current study aims to assess the relationship between implant size and the development of complications following augmentation mammaplasty.
A retrospective chart review of patients undergoing primary breast augmentation at the Westmount Institute of Plastic Surgery between January 2000 and December 2021 was conducted. Demographics, implant characteristics, surgical technique, postoperative complications, and follow-up times were recorded. Univariate logistic regression was used to identify independent predictors, which were then included in multivariate logistic regressions of implant volume and implant volume/body mass index (BMI) ratio regarding complications.
A total of 1017 patients (2034 breasts) were included in this study. The average implant volume used was 321.4 ± 57.5 cm (range: 110-605). Increased volume and volume/BMI ratio were associated with a significant increase in risk of implant rupture (odds ratio = 1.012, < 0.001 and 1.282, < 0.001 respectively). Rates of asymmetry were significantly associated with increases in implant volume and volume/BMI ratio (odds ratio = 1.005, = 0.004 and 1.151, < 0.001, respectively). No single implant volume or volume/BMI ratio above which risks of complications significantly increase was identified.
Implant rupture and postoperative asymmetries are positively correlated with bigger implant volumes. Implant size could likely be a useful independent predictor of certain complications, especially in patients with high implant to BMI ratios.
关于植入体大小作为初次隆乳术中并发症的独立危险因素，目前尚无共识。选择合适的植入体体积是术前规划过程的一个组成部分。本研究旨在评估植入体大小与隆乳术后并发症发生之间的关系。
对2000年1月至2021年12月在韦斯特蒙特整形外科研究所接受初次隆乳术的患者进行回顾性病历审查。记录人口统计学资料、植入体特征、手术技术、术后并发症及随访时间。采用单因素逻辑回归确定独立预测因素，然后将其纳入关于并发症的植入体体积和植入体体积/体重指数（BMI）比值的多因素逻辑回归分析。
本研究共纳入1017例患者（2034侧乳房）。所用植入体的平均体积为321.4±57.5 cm³（范围：110 - 605）。体积增加和体积/BMI比值增加与植入体破裂风险显著增加相关（优势比分别为1.012，P<0.001和1.282，P<0.001）。不对称率与植入体体积和体积/BMI比值增加显著相关（优势比分别为1.005，P = 0.004和1.151，P<0.001）。未发现单一的植入体体积或体积/BMI比值，超过该值并发症风险会显著增加。
植入体破裂和术后不对称与更大的植入体体积呈正相关。植入体大小可能是某些并发症的有用独立预测因素，尤其是在植入体与BMI比值高的患者中。
