Amro Chris, Ryan Isabel A, Lemdani Mehdi S, Ewing Jane N, Gala Zachary, Broach Robyn B, Fischer John P
Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14th Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA.
Aesthetic Plast Surg. 2025 Jan 2. doi: 10.1007/s00266-024-04652-4.
Breast reduction surgery addresses both functional complaints and aesthetic concerns. Two commonly used incision patterns in the US are the Wise and vertical patterns, but there are limited data comparing their clinical and quality of life (QoL) outcomes. This study evaluates and compares these outcomes between the two techniques.
A retrospective review from 2016 to 2022 examined subjects who underwent breast reduction with either vertical or Wise incision patterns. A propensity-scored match was performed based on age, body mass index (BMI), ptosis grade, and breast tissue removal. Surgical and patient-reported outcomes (BREAST-Q) were analysed.
Out of 379 patients, a total of 92 breasts (46 patients) were identified after propensity-score matching, with a mean age of 30.4 years and BMI of 26.5 kg/m. Vertical incisions were more likely to have the superomedial pedicle utilized and a larger nipple diameter. There was no significant difference in ptosis grade and tissue removal. There were no differences in clinical outcomes, aesthetic outcomes, reoperations, readmissions, or emergency room visits (p > 0.05). QoL analysis identified a significant improvement within both cohorts across domains: satisfaction with breast, psychosocial well-being, and physical well-being (p < 0.001). However, patients with the Wise pattern technique demonstrated a significant improvement in sexual well-being (p = 0.002).
Both the vertical and Wise incision patterns are safe and provide significant QoL improvements. While both techniques improve multiple QoL domains, the Wise pattern offers additional benefits in sexual well-being. These findings can guide surgeons in discussing outcomes with patients.
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缩乳手术既能解决功能方面的问题，也能处理美观方面的顾虑。美国常用的两种切口方式是 Wise 式和垂直式，但比较它们临床效果和生活质量（QoL）结果的数据有限。本研究评估并比较了这两种技术的这些结果。
对 2016 年至 2022 年的病例进行回顾性研究，纳入采用垂直或 Wise 切口方式进行缩乳手术的受试者。根据年龄、体重指数（BMI）、乳房下垂程度和切除的乳腺组织进行倾向得分匹配。分析手术和患者报告的结果（BREAST-Q）。
在 379 例患者中，经过倾向得分匹配后共确定了 92 个乳房（46 例患者），平均年龄 30.4 岁，BMI 为 26.5kg/m²。垂直切口更有可能采用上内侧蒂，乳头直径更大。乳房下垂程度和切除组织量无显著差异。临床结果、美学效果、再次手术、再次入院或急诊就诊情况均无差异（p>0.05）。生活质量分析表明，两个队列在各个领域均有显著改善：对乳房的满意度、心理社会幸福感和身体健康（p<0.001）。然而，采用 Wise 式技术的患者在性健康方面有显著改善（p = 0.002）。
垂直和 Wise 切口方式均安全有效，能显著改善生活质量。虽然两种技术都能改善多个生活质量领域，但 Wise 式在性健康方面有额外益处。这些发现可为外科医生与患者讨论手术结果提供指导。
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