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Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis
Min-Xia Zhang1,2, Chun-Ye Chen1,2, Qing-Qing Fang1,2
1Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China.
Background:
Reduction mammoplasty (RM) is a proven method of treating macromastia, but the risk factors for postoperative complications have not been clearly identified. Through this meta-analysis, the authors aimed to identify the risk factors of RM complications.
Methods:
An extensive search of the literature describing complications after RM was performed using the PubMed Central, Embase, and Cochrane databases. The following risk factors were extracted: age, body mass index (BMI), tissue resection weight per breast (TRW), smoking and radiation therapy. Odds ratios (OR) were pooled with 95% confidence intervals (CI) to evaluate the relationship between these risk factors and complications after RM.
Results:
A total of 16 unique studies including 10 593 patients were included in the final analysis. It showed that there was a significant difference in complications in BMI ≥30 kg/m2 (OR 0.73; 95% CI: 0.61-0.89, p = 0.001) and smoking (OR 1.56; 95% CI: 0.98-2.49, p = 0.06). Infection in those with BMI ≥30 kg/m2 showed a significant difference (OR 0.68; 95% CI: 0.52-0.89, p = 0.004), as well as wound dehiscence in smokers (OR 2.73; 95% CI: 1.60-4.67, p = 0.0002) and infection in irradiated breasts (OR 20.38; 95% CI: 3.42-121.35, p = 0.0009). However, there was no significant difference in age ≥50 years (OR 0.96; 95% CI: 0.71-1.29, p = 0.78), combined TRW ≥1000 g (OR 1.04; 95% CI: 0.43-2.50, p = 0.93).
Conclusions:
BMI ≥30 kg/m2 and smoking increase the risk of complications. Persons who are obese or irradiated are more likely to develop infections, and smokers experienced a higher incidence of wound dehiscence than did nonsmokers. However, patients aged ≥50 years and TRW ≥1000 g are not associated with complications from RM.
Insights
Obesity (BMI ≥30 kg/m2) and smoking are significant risk factors for complications following reduction mammoplasty (RM). Obese or irradiated patients are prone to infection, while smokers face higher wound dehiscence rates.
Area of Science:
- Plastic Surgery
- Surgical Complications
- Meta-Analysis
Background:
- Reduction mammoplasty (RM) effectively treats macromastia.
- Identifying risk factors for RM complications is crucial for patient safety.
Purpose of the Study:
- To conduct a meta-analysis identifying risk factors associated with postoperative complications after reduction mammoplasty.
Main Methods:
- Systematic literature review of PubMed Central, Embase, and Cochrane databases.
- Extracted data on age, BMI, tissue resection weight (TRW), smoking, and radiation therapy.
- Pooled odds ratios (OR) with 95% confidence intervals (CI) to assess risk factor association.
Main Results:
- Analysis of 16 studies (10,593 patients) revealed significant complication risks for BMI ≥30 kg/m2 (OR 0.73) and smoking (OR 1.56).
- Higher infection rates observed in obese patients (BMI ≥30 kg/m2, OR 0.68) and irradiated breasts (OR 20.38).
- Smokers showed increased wound dehiscence (OR 2.73), while age ≥50 and TRW ≥1000 g were not significant risk factors.
Conclusions:
- BMI ≥30 kg/m2 and smoking are confirmed risk factors for reduction mammoplasty complications.
- Obesity and radiation therapy increase infection risk; smoking elevates wound dehiscence risk.
- Age ≥50 years and substantial tissue resection (TRW ≥1000 g) do not correlate with increased RM complications.
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