Meretsky Christopher R, Knecht Erik M, Schiuma Anthony T
Surgery, St. George's University School of Medicine, Great River, USA.
Surgery, Chicago Medical School at Rosalind Franklin University, Illinois, USA.
Cureus. 2024 Sep 21;16(9):e69846. doi: 10.7759/cureus.69846. eCollection 2024 Sep.
Breast augmentation remains a highly sought-after cosmetic surgery, with various techniques available to enhance breast size using implants or fat transfer. This systematic review, spanning studies from 2003 to 2024 and adhering to PRISMA guidelines, evaluates the outcomes of different surgical approaches concerning scar quality, postoperative pain, patient satisfaction, and complications. The periareolar technique emerges as a favorable option, offering minimal postoperative pain, high patient satisfaction, and precise surgical control with subtle scarring. Transumbilical breast augmentation (TUBA) is noted for its scar-free approach, resulting in low pain and high satisfaction, though it requires specialized training and cannot use prefilled implants. The review highlights the varying complication rates across techniques: modern silicone implants, while safer than earlier injectable materials, still face risks such as rupture and capsular contracture. Autologous fat grafting is generally safer but can lead to issues like erythema and abscesses. The use of effective acellular dermal matrix (ADM) is linked to higher rates of seroma and infection compared to non-ADM procedures, although sterile human ADM shows a lower risk profile. The study underscores the importance of personalized surgical planning to optimize outcomes, as each technique offers distinct benefits and challenges. The findings suggest that future research should aim to refine these techniques and address their associated complications to further enhance patient satisfaction and surgical outcomes in breast augmentation.
隆胸仍然是一项备受追捧的整形手术，有多种技术可用于通过植入物或脂肪移植来增大乳房尺寸。这项系统评价涵盖了2003年至2024年的研究，并遵循PRISMA指南，评估了不同手术方法在疤痕质量、术后疼痛、患者满意度和并发症方面的结果。乳晕周围技术是一个不错的选择，术后疼痛轻微，患者满意度高，手术控制精确，疤痕不明显。经脐隆胸（TUBA）以其无痕方法著称，疼痛轻且满意度高，不过它需要专门培训，且不能使用预装植入物。该评价强调了不同技术的并发症发生率各不相同：现代硅胶植入物虽然比早期的可注射材料更安全，但仍面临破裂和包膜挛缩等风险。自体脂肪移植通常更安全，但可能导致红斑和脓肿等问题。与非脱细胞真皮基质（ADM）手术相比，使用有效的ADM与血清肿和感染发生率较高有关，尽管无菌人ADM的风险较低。该研究强调了个性化手术规划对优化结果的重要性，因为每种技术都有独特的益处和挑战。研究结果表明，未来的研究应致力于改进这些技术并解决其相关并发症，以进一步提高隆胸手术的患者满意度和手术效果。
