Halawani Ibrahim R, Alalawi Shahad, Alyamani Sarah, Alhithlool Abdulmalek W, Ahmed Ferdous A, Asali Iraf, Alghamdi Abdulrahman A, Al Noman Hatem
From the College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Plastic and Reconstructive Surgery, King Fahad General Hospital, Jeddah, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2025 Jun 26;13(6):e6913. doi: 10.1097/GOX.0000000000006913. eCollection 2025 Jun.
Juvenile macromastia is a rare condition of significant breast enlargement in adolescents. Reduction mammoplasties offer relief, but data on complications in adolescents are rare as opposed to data on adults. We reviewed the outcomes, complications, recurrence, and patient satisfaction after reduction mammoplasties in adolescents.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a thorough search across various electronic databases for "juvenile macromastia" and "breast reduction." Only studies on women diagnosed with juvenile macromastia before 21 years of age who underwent breast reduction surgery were included. The methodological index for nonrandomized studies was used to assess study quality.
This meta-analysis pooled data from 11 studies. The overall pooled postoperative complication rate, based on random-effects models, was 17.5% (95% confidence interval: 9.7%-29.5%). The recurrence rate was 15.6% (95% confidence interval: 8.5%-26.9%), ranging from 0% to 52.9%. Complication rates varied widely across studies, with wound dehiscence, hematoma, and infection being the most common. Severe complications, such as nipple necrosis, were rare. Low publication bias was observed for postoperative complications, but potential bias was noted for recurrence outcomes.
The findings emphasize the need for standardized reporting and long-term follow-up to improve the reliability of pooled estimates and to guide clinical decision-making. The high recurrence risk emphasized the need for individualized surgical approaches and careful management of risk factors, such as obesity and smoking, to improve outcomes. Despite the variability, the benefits of surgery generally outweighed the risks, with high patient satisfaction reported in the included studies.
青少年巨乳症是青少年乳房显著增大的一种罕见病症。乳房缩小术可缓解症状，但与成人相关数据相比，青少年并发症的数据很少。我们回顾了青少年乳房缩小术后的结果、并发症、复发情况及患者满意度。
按照系统评价和荟萃分析的首选报告项目指南，我们在各种电子数据库中全面搜索了“青少年巨乳症”和“乳房缩小术”。仅纳入了21岁之前被诊断为青少年巨乳症且接受了乳房缩小手术的女性研究。采用非随机研究的方法学指标来评估研究质量。
这项荟萃分析汇总了11项研究的数据。基于随机效应模型，总体汇总术后并发症发生率为17.5%（95%置信区间：9.7%-29.5%）。复发率为15.6%（95%置信区间：8.5%-26.9%），范围从0%至52.9%。各研究的并发症发生率差异很大，伤口裂开、血肿和感染最为常见。乳头坏死等严重并发症很少见。术后并发症观察到低发表偏倚，但复发结果存在潜在偏倚。
研究结果强调需要标准化报告和长期随访，以提高汇总估计的可靠性并指导临床决策。高复发风险强调需要个体化手术方法并谨慎管理肥胖和吸烟等风险因素，以改善手术效果。尽管存在变异性，但手术的益处总体上超过风险，纳入研究报告患者满意度较高。
