Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis

Abstract

BackgroundReduction 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.MethodsAn 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.ResultsA 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).ConclusionsBMI ≥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.

Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study

“…Several risk factors associated with the occurrence of fat necrosis after surgery have been proposed, which include neoadjuvant chemotherapy, adjuvant radiotherapy, high BMI, and uncontrolled underlying disease [37][38][39][40]. However, there was no significant factor associated with fat necrosis in our study.…”

Natural Course of Fat Necrosis After Breast Reconstruction: A 10-Year Follow-Up Study

“…Several risk factors associated with the occurrence of fat necrosis after surgery have been proposed, which include neoadjuvant chemotherapy, adjuvant radiotherapy, high BMI, and uncontrolled underlying disease (37)(38)(39)(40). However, there was no signi cant factor associated with fat necrosis in our study.…”

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

“…8 Factors associated with increased complication rates are an incorrect choice of surgical technique, body mass index ≥30 kg/m 2 , higher resection weight, radiation therapy, smoking, and diabetes. 9,10 The choice of dissection technique may also play a role in the incidence of wound-healing disorders. While traditional electrosurgical devices are considered the standard of care, they also use continuous-wave, highfrequency electrical current of alternating polarity, thereby generating considerable amounts of thermal energy.…”

“…Mostly, complications seem to be minor, with wound‐healing disorders being the most common 8 . Factors associated with increased complication rates are an incorrect choice of surgical technique, body mass index ≥30 kg/m 2 , higher resection weight, radiation therapy, smoking, and diabetes 9,10 …”