Sofianos Chrysis, Kruger Kyara
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Surgical Research Group, Netcare Milpark, Johannesburg, South Africa.
Plast Reconstr Surg Glob Open. 2025 Mar 12;13(3):e6609. doi: 10.1097/GOX.0000000000006609. eCollection 2025 Mar.
Global surgery is a multidisciplinary field that aims to deliver equitable and improved surgical services. Surgical care has been previously considered to play a limited role in the global burden of disease, in part due to its complexity and associated expense. A functional health system mandates high-quality, accessible, and timely surgical care.
Literature was reviewed on the role of plastic and reconstructive surgery in global surgery programs, reduction mammaplasty, and quality of life (QoL). Definitions of emergency and essential surgical care were explored to understand which surgical procedures are included in these programs. Reduction mammaplasty is the most researched aesthetic surgery procedure when considering QoL.
The surgical conditions treated by plastic surgeons comprise a large proportion of the global surgical disease burden and disproportionately affect individuals in low- to middle-income countries. Over time, reconstructive surgery has gained equivalence to other surgical fields, partly due to a broader understanding of health; the need for psychological well-being; and the fact that some aesthetic surgery procedures are now considered reconstructive, such as a reduction mammaplasty. Essential surgery comprises low-cost, basic surgical procedures that prevent disability or life-threatening complications and may be performed at the district hospital level. Reconstructive plastic surgery improves QoL in multiple domains, including reduction mammaplasties.
The cost-effectiveness and QoL improvements of reduction mammaplasty have been elucidated; therefore, this can make a real difference for many patients in developing countries. Consideration should be given to expanding the essential surgical care package to include reduction mammaplasty.
全球外科是一个多学科领域，旨在提供公平且改善后的外科服务。外科护理先前被认为在全球疾病负担中作用有限，部分原因在于其复杂性和相关费用。一个有效的卫生系统要求提供高质量、可及且及时的外科护理。
对整形与重建外科在全球外科项目中的作用、缩乳术及生活质量（QoL）方面的文献进行了综述。探讨了急诊和基本外科护理的定义，以了解这些项目包含哪些外科手术。在考虑生活质量时，缩乳术是研究最多的美容外科手术。
整形外科医生治疗的外科疾病在全球外科疾病负担中占很大比例，且对低收入和中等收入国家的个体影响尤为严重。随着时间推移，重建外科已与其他外科领域具有同等地位，部分原因是对健康有了更广泛的认识；对心理健康的需求；以及现在一些美容外科手术（如缩乳术）被视为重建手术这一事实。基本外科手术包括低成本的基本外科操作，可预防残疾或危及生命的并发症，且可在地区医院层面进行。整形重建外科在多个领域改善了生活质量，包括缩乳术。
缩乳术的成本效益和生活质量改善已得到阐明；因此，这对发展中国家的许多患者可能会产生切实影响。应考虑扩大基本外科护理套餐，将缩乳术纳入其中。
