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Efficacy and Safety of the L-Scar Technique in Breast Surgery: A Systematic Review and Meta-Analysis
Pedro Lucas Machado Magalhães1, Bernardo Gabriele Collaco2, Milena Gonçalves Guerreiro3
1Faculty of Medicine, Institute of Medical Education, Angra dos Reis, RJ, Brazil. pedrolucas.magalhaes@icloud.com.
Background:
The L-scar technique has emerged as a promising alternative in breast surgery, aiming to reduce visible scarring while preserving aesthetics and minimizing complications. Despite growing clinical interest, comprehensive evaluations of its outcomes remain scarce.
Methods:
We conducted a systematic review and meta-analysis following PRISMA and Cochrane guidelines. Studies were included if they assessed the L-scar technique in breast procedures, including reduction mammaplasty, mastopexy and augmentation, and reported on postoperative complications or patient satisfaction. Searches were performed in PubMed, Embase, Scopus, Web of Science, and Cochrane through December 2024. Pooled prevalences were calculated using a random-effects model, and heterogeneity was assessed via the I2 statistic. Risk of bias was evaluated using ROBINS-I.
Results:
Twelve studies comprising 3,130 patients were included. The pooled incidence of complications was low across most outcomes: breast asymmetry (1.95%), dog-ear deformity (5%), scar hypertrophy (1.7%), wound dehiscence (1.8%), seroma (0.6%), hematoma (1.2%), infection (0.6%), fat necrosis (5.8%), partial nipple areolar complex (NAC) necrosis (0.4%), and no reported cases of complete NAC necrosis. Sensory complications included nipple sensation loss (2.2%) and reduction (20%). Patient satisfaction was high, with a pooled rate of 92%. All estimates include 95% confidence intervals. Heterogeneity was moderate to high for some outcomes, but sensitivity analyses confirmed the robustness of most estimates.
Conclusions:
The L-scar technique demonstrates a favorable safety profile, minimal visible scarring, and excellent satisfaction rates. It appears to be a safe and effective option within the spectrum of contemporary breast reshaping techniques. Further prospective studies are warranted to validate long-term outcomes.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
