Breast Surgery Unit, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
J Plast Reconstr Aesthet Surg. 2023 Aug;83:380-395. doi: 10.1016/j.bjps.2023.04.003. Epub 2023 Apr 21.
Breast ptosis is characterized by the inferolateral descent of the glandular area and nipple-areola complex. A high degree of ptosis may negatively impact a woman's attractiveness and self-confidence. There are various classifications and measurement techniques for breast ptosis used as references in the medical and garment industry. A practical and comprehensive classification will provide accurate standardized definitions of the degrees of ptosis to facilitate the development of corrective surgeries and well-fitting undergarments for women in need.
A systematic review on the classification and assessment techniques to measure breast ptosis was carried out based on the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the modified Newcastle-Ottawa scale for observational studies, whereas the Revised Cochrane risk-of-bias tool for randomized trials (RoB2) was used to evaluate randomized studies.
Of 2550 articles identified in the literature search, 16 observational and 2 randomized studies describing the classification and assessment techniques of breast ptosis were included in the review. A total of 2033 subjects were involved. Half of the total observational studies had a Newcastle-Ottawa scale score of 5 and above. In addition, all randomized trials recorded a low overall bias.
A total of 7 classifications and 4 measurement techniques for breast ptosis were identified. However, most studies did not demonstrate a clear derivation of sample size beside lacking robust statistical analysis. Hence, further studies that apply the latest technology to combine the strength of previous assessment techniques are needed to develop better classification system that is applicable to all affected women.
乳房下垂的特征是腺体区域和乳晕复合体的下外侧下降。高度下垂可能会影响女性的吸引力和自信心。医学和服装行业参考使用了各种乳房下垂的分类和测量技术。实用且全面的分类将为下垂程度提供准确的标准化定义，有助于开发针对有需要的女性的矫正手术和合适的内衣。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，对乳房下垂的分类和评估技术进行了系统评价。使用改良的纽卡斯尔-渥太华量表（NOS）评估观察性研究的偏倚风险，而修订后的 Cochrane 随机试验偏倚风险工具（RoB2）用于评估随机研究。
在文献检索中，共确定了 2550 篇文章，其中包括 16 项描述乳房下垂分类和评估技术的观察性研究和 2 项随机研究。共有 2033 名受试者参与。半数的观察性研究NOS 评分为 5 分及以上。此外，所有的随机试验均记录了整体低度偏倚。
共确定了 7 种乳房下垂分类和 4 种测量技术。然而，大多数研究除了缺乏稳健的统计分析外，没有明确说明样本量的推导。因此，需要进一步的研究应用最新技术结合以前评估技术的优势，以开发适用于所有受影响女性的更好的分类系统。
