Aesthet Surg J. 2024 Nov 15;44(12):NP852-NP861. doi: 10.1093/asj/sjae168.
Reduction mammaplasty can provide symptomatic relief to patients suffering from macromastia; however, complications such as dehiscence are common. It is unknown if the presence of complications affects patient-reported outcomes.
The aim of this study was to determine the risk factors for the development of complications, and to examine the correlation between postoperative complications and patient-reported outcomes in reduction mammaplasty.
A single-center retrospective chart review was undertaken of patients who received reduction mammaplasties (CPT 19318), performed by 13 surgeons, between January 2017 and February 2023. Breast cancer cases and oncoplastic reconstructions were excluded. Patients with >1 complication were grouped into the complications cohort. Satisfaction was assessed by administering the BREAST-Q survey.
A total of 661 patients were included for analysis, 131 of whom developed at least 1 complication. Patients in the group with complications had significantly higher average ages and BMIs, and a higher likelihood of hypertension and diabetes (P < .01). Among 180 BREAST-Q responders, 41 had at least 1 complication. There were no significant differences between the 2 groups (complications vs no complications) across survey outcomes. Although obese patients were more likely to develop infection and require revisions (P < .01), no significant differences in subgroup analysis of patient-reported outcomes focusing on obese patients were observed.
Obesity, hypertension, and diabetes were associated with postoperative complications of reduction mammaplasty. Patients with complications had similar postoperative BREAST-Q satisfaction to patients without complications. Although risk optimization is critical, patients and surgeons should be reassured that satisfaction may be achieved even in the event of a complication.
缩乳术可以为巨乳症患者提供症状缓解，但常见并发症如切口裂开。目前尚不清楚并发症的存在是否会影响患者报告的结果。
本研究旨在确定并发症发生的危险因素，并研究缩乳术后并发症与患者报告结果之间的相关性。
对 2017 年 1 月至 2023 年 2 月期间由 13 名外科医生进行的缩乳术（CPT 19318）患者进行了单中心回顾性病历回顾。排除乳腺癌病例和肿瘤整形重建。将有>1 种并发症的患者归入并发症组。通过 BREAST-Q 调查评估满意度。
共纳入 661 例患者进行分析，其中 131 例患者至少发生 1 种并发症。并发症组患者的平均年龄和 BMI 显著较高，且高血压和糖尿病的发生概率更高（P <.01）。在 180 名 BREAST-Q 应答者中，有 41 名至少有 1 种并发症。2 组（有并发症组和无并发症组）的调查结果无显著差异。尽管肥胖患者更易发生感染和需要修复（P <.01），但对肥胖患者进行的患者报告结果亚组分析未观察到显著差异。
肥胖、高血压和糖尿病与缩乳术的术后并发症相关。有并发症的患者与无并发症的患者相比，术后 BREAST-Q 满意度相似。尽管风险优化至关重要，但患者和外科医生应放心，即使发生并发症也可能获得满意的结果。
