Breast Reduction Research Articles

Machine Learning, Deep Learning, Artificial Intelligence and Aesthetic Plastic Surgery: A Qualitative Systematic Review.

This systematic review aims to assess the use of machine learning, deep learning, and artificial intelligence in aesthetic plastic surgery. This qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. To analyze quality risk-of-bias assessment of all included articles, we used the ROBINS-I tool for non-randomized studies. We searched for studies with the following MeSH terms: Machine Learning OR Deep Learning OR Artificial intelligence AND Plastic surgery on MEDLINE/PubMed, EMBASE, and Cochrane Library, from inception until July 2024 without any filter applied. A total of 2,148 studies were screened and 41 were fully reviewed. We conducted article extraction, screening, and full text review using the rayyan tool. Eighteen studies were ultimately included in this review, describing the use of machine learning, deep learning and artificial intelligence in aesthetic plastic surgery. All studies were published from 2019 to 2024. Articles varied regarding the population studied, type of machine learning (ML), Deep Learning Model (DLM), Artificial Intelligence (AI) used, and aesthetic plastic surgery type. Of the eighteen studies, we included the following aesthetic plastic surgeries: augmentation mastopexy, breast augmentation, reduction mammoplasty, rhinoplasty, facial rejuvenation surgery, including facelift surgery; blepharoplasty, and body contouring. Image-based with AI, ML, and DLMs algorithms were used in these studies to improve human decision-making and identified factors associated with postoperative complications. AI, ML, and DL algorithms offer immense potential to transform the aesthetic plastic surgery field. By meticulously analyzing patient data, these technologies may, in the future, help optimize treatment plans, predict potential complications, and more clearly elucidate patient concerns, improving their ability to make informed decisions. The drawback, as with preoperative surgical simulation, is that patients may see an AI-generated image that is to their liking, but impossible to achieve; great care is needed when using such tools in order to not create unrealistic expectations. Ultimately, the old plastic surgery adage of ''under-promise and over-deliver'' will continue to hold true, at least for the foreseeable future. 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 . Study registration A review protocol for this systematic review was registered at PROSPERO CRD42024567461.

Seasonal Impact on Wound Healing and Surgical Site Infections after Reduction Mammoplasty.

Background: The incidence of reduction mammoplasty has been steadily increasing over recent decades. Surgical site infections (SSIs) represent a common yet preventable complication across surgical disciplines. Studies across various surgical specialties have indicated a seasonal influence on SSIs, primarily correlated with higher temperatures and humidity. However, there remains a scarcity of clear data regarding the seasonal effects on complications specifically in breast surgery. Methods: We conducted a retrospective review encompassing all patients who underwent primary bilateral reduction mammoplasties at our institution between 1 June 2016, and 1 September 2019. The data collected included patient demographics, surgical details, and postoperative complications. The rates of SSIs and wound healing disturbances (WHDs) were correlated with local meteorological data at the time of surgery. Results: A total of 808 patients (1616 breasts) met the inclusion criteria. The mean age was 41 ± 14.8 years, with a mean BMI of 28.9 ± 5.2 kg/m2 and a mean follow-up duration of 8.9 ± 9.8 months. Nineteen cases (2.35%) of surgical site infections and 77 cases (9.52%) of wound healing disturbances were reported. No statistically significant increase in the risk of SSIs (p = 0.928) or WHDs (p = 0.078) was observed during the warmer months of the year. Although no specific risk factors were identified for surgical site infections, both resection weight (p < 0.001) and diabetes mellitus (p = 0.001) demonstrated increased risks for wound healing disturbances. Conclusions: While seasonal temperature variations have been shown to impact SSIs and WHDs in body contouring procedures, our findings suggest that breast reduction surgery may not be similarly affected.

The “Mosque Tower Pattern” for the Preoperative Marking of Reduction Mammaplasty

Background: Breast reduction, the seventh most performed plastic surgery globally, has witnessed a significant increase in procedures over recent years. Various techniques exist, each with its advantages and complications, emphasizing the critical role of preoperative marking. Although existing literature focuses on different reduction mammaplasty techniques, limited attention is given to surgical preoperative marking. This study introduces a “mosque tower” pattern combined with a superomedial pedicle, aiming to minimize complications and standardize the design based on individualized factors such as patient characteristics and predicted breast reduction weight. Methods: The retrospective case series includes 103 women who underwent reduction mammaplasty between 2017 and 2020. Surgical marking is described, and complications are recorded. The study categorizes breasts into three groups based on key-hole dimensions, correlating them with predicted resection weight. Statistical analysis establishes a rationale formula for selecting key-hole size. Results: A total of 175 breasts were reduced in 103 women with an average follow-up of 29.8 months. The mean resection weight was 883 g per breast (range: 490–2531). A complication rate of 8% was observed, with only 2.8% experiencing wound breakdown, notably lower than reported rates in other studies. Key-hole dimension as a predicting variable was correlated significantly with resection weight. Conclusions: The mosque tower pattern proves to be an effective, safe, and reproducible method for preoperative marking in reduction mammaplasty. The study emphasizes the importance of individualized planning to achieve satisfactory results, particularly for surgeons in their early practice.

Reduction mammaplasty relieves depression in women with macromastia: A systematic review

A total of 71,364 breast reductions were performed in 2022, which demonstrates a 54% increase from 2019. Women most often seek breast reduction surgery for pain, but psychological symptoms may be equally distressing, particularly those who are younger. These women may also suffer low self-esteem, inhibitions in intimacy, and reluctance to exercise, which may contribute to depressive symptoms. A systematic review was conducted using PRISMA guidelines and registered on PROSPERO (CRD42023456884). Cochrane Library, Embase, and Pubmed were searched for RCTs in English irrespective of timeframe. The studies were screened using the RoB2 tool, and data was extracted using standardized tables. The search strategy yielded 84 references, and only three were eligible for inclusion. The sample size collectively amounted to 193. The tools used to assess depressive symptoms were the Beck Depression Inventory, a modification of this tool, and the Hospital Anxiety Depression Score. All three studies showed a significant reduction in depression scores. Breast hypertrophy may cause impairment in several key psychological domains including depression, which may be relieved with surgery. Standardized assessment tools and scoring systems may enable more comprehensive evaluation and potentially lead to guidelines defining broader criteria as indications for surgery. Further investigation into the differences between women who seek breast reduction surgery versus those who do not may provide insights into other contributing factors that may be at play. Further trials should be designed with longer durations of follow-up to investigate the long-term effects of breast reduction surgery.

Nipple/Infra-Mammary Fold Distance: An Indicator for Aesthetic Outcome in Reduction Mammaplasty

Nipple/Infra-Mammary Fold Distance: An Indicator for Aesthetic Outcome in Reduction Mammaplasty

Single-cell transcriptional atlas of human breast cancers and model systems.

Breast cancer's complex transcriptional landscape requires an improved understanding of cellular diversity to identify effective treatments. The study of genetic variations among breast cancer subtypes at single-cell resolution has potential to deepen our insights into cancer progression. In this study, we amalgamate single-cell RNA sequencing data from patient tumours and matched lymph metastasis, reduction mammoplasties, breast cancer patient-derived xenografts (PDXs), PDX-derived organoids (PDXOs), and cell lines resulting in a diverse dataset of 117 samples with 506719 total cells. These samples encompass hormone receptor positive (HR+), human epidermal growth factor receptor 2 positive (HER2+), and triple-negative breast cancer (TNBC) subtypes, including isogenic model pairs. Herein, we delineated similarities and distinctions across models and patient samples and explore therapeutic drug efficacy based on subtype proportions. PDX models more closely resemble patient samples in terms of tumour heterogeneity and cell cycle characteristics when compared with TNBC cell lines. Acquired drug resistance was associated with an increase in basal-like cell proportions within TNBC PDX tumours as defined with SCSubtype and TNBCtype cell typing predictors. All patient samples contained a mixture of subtypes; compared to primary tumours HR+ lymph node metastases had lower proportions of HER2-Enriched cells. PDXOs exhibited differences in metabolic-related transcripts compared to PDX tumours. Correlative analyses of cytotoxic drugs on PDX cells identified therapeutic efficacy was based on subtype proportion. We present a substantial multimodel dataset, a dynamic approach to cell-wise sample annotation, and a comprehensive interrogation of models within systems of human breast cancer. This analysis and reference will facilitate informed decision-making in preclinical research and therapeutic development through its elucidation of model limitations, subtype-specific insights and novel targetable pathways. Patient-derived xenografts models more closely resemble patient samples in tumour heterogeneity and cell cycle characteristics when compared with cell lines. 3D organoid models exhibit differences in metabolic profiles compared to their in vivo counterparts. A valuable multimodel reference dataset that can be useful in elucidating model differences and novel targetable pathways.

Abdominal Etching-A Novel Classification Method for Surgical Approach.

The abdomen is the aesthetic and physical center of the body. Abdominal etching is used to enhance the appearance of the abdominal musculature. Body contouring and abdominal etching are popular among both men and women, and these procedures have been shown to result in high patient satisfaction and are considered safe. The aim of this study was to describe a novel classification for abdominal etching based on the senior author's technique and experience. This single surgeon, nonrandomized, retrospective study was conducted from December 2016 to September 2022. Patients were classified into 4 groups based on their body habitus, abdominal skin pinch test and skin quality, and the surgical plan was tailored accordingly. Sixty-two patients (42 male) with an average age of 36years underwent abdominal etching during the study period. Subgrouping included 4 (6.45%) in Class 1, 22 (35.5%) in Class 2, 32 (51.6%) in Class 3 and 4 (6.45%) in Class 4. The most common complication was seroma. Concomitant procedures included silicone implants to the pectoral region (male), fat injection to the buttocks, breast reduction and mastopexy and treatment of post-liposuction irregularities. The abdominal etching technique is safe and reproducible. It has demonstrated long-lasting results and high patient satisfaction. Our classification of patients will enable surgeons to better understand the problem presented and provide aesthetic and efficient results. Use of these guidelines and tailoring treatment options will further improve patient and physician satisfaction. 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.

In Vitro Treatment with Metformin Significantly Reduces Senescent B Cells Present in the Adipose Tissue of People with Obesity

BackgroundOur previous work has shown that senescent B cells accumulate in the human adipose tissue (AT) from people with obesity, where they express transcripts for markers associated with the senescence-associated secretory phenotype (SASP) and secrete multiple inflammatory mediators. These functions of AT-derived B cells are metabolically supported. ObjectivesTo show that Metformin (MET), a widely used hypoglycemic and antidiabetic drug, is able at least in vitro to decrease frequencies, secretory profile, and metabolic requirements of senescent B cells isolated from the AT from people with obesity. MethodsWe recruited adult females with obesity (n = 8, age 40 ± 2 y, BMI range: 33–42) undergoing breast reduction surgery, who donated their discarded subcutaneous AT. B cells from stromal vascular fractions isolated after collagenase digestion of the AT were evaluated after in vitro incubation with MET (1 mM × 106 B cells) or with a medium for the following measures. The expression of transcripts for SASP-associated markers (p16INK4a and p21CIP1/WAF1) measured by quantitative polymerase chain reaction (qPCR); secretion of inflammatory cytokines (TNF-α, IL-6, IFN-γ and IL-17A) measured by a Cytometric Bead Array); metabolic characteristics as identified by a glycolytic test and Seahorse technology, and by the expression of transcripts for glucose transporters and metabolic enzymes involved in glucose metabolic pathways, measured by qPCR. To examine differences between MET-treated compared with untreated groups, paired Student’s t tests (two-tailed) were employed. ResultsMET in vitro was able to reduce frequencies and numbers of senescent B cells, as identified by staining with β-galactosidase, as well as the secretion of inflammatory cytokines, the expression of transcripts for SASP, and metabolic markers that support intrinsic B cell inflammation. ConclusionsOur results provide evidence to support the beneficial effects of MET in reducing AT-related inflammation through its effects on senescent B cells.

Modified McKissock Technique for Secondary Breast Reduction - A Prospective Study on Safety, Surgical and Aesthetic Outcomes.

Numbers of secondary breast reductions are increasing but those are potentially associated with higher complication rates than primary mammaplasty. Necrosis of the Nipple-Areola-Complex (NAC) is a devastating complication that can occur after repeated NAC transposition, particularly when the initially used pedicle is unknown. Thus, the authors established a modification of McKissock's technique for secondary breast reductions including three pedicle components to ensure safe vascular supply of the NAC. The presented technique incorporates a superior and inferior dermoglandular pedicle according to McKissock and an additional central pedicle. The technique was applied for secondary breast reduction in a series of 25 breasts (14 patients: 11 bilateral, 3 unilateral). Complication rates, pre- and postoperative BREAST-Q scores, and aesthetic outcomes were evaluated. Mean resection weight was 299 g (range, 40-646), and the NAC was transposed by 4.2 cm on average (range, 1-10). No case of NAC-necrosis was observed, and comparison of pre- and postoperative BREAST-Q values indicated substantial improvement in all domains. Postoperatively, 84.6% of patients reported excellent satisfaction with breast appearance. According to those results, the modified McKissock-technique is a safe technique for patients requiring secondary breast reduction, even if the primarily used pedicle is unknown. Additionally, the established technique is associated with improved postoperative patient-reported outcomes and yields aesthetically favorable results.

Advancing Reduction Mammaplasty Surgery: Advancements and Outcomes with Tumescent Local Anaesthesia.

Tumescent local anaesthesia (TLA) is a method of anaesthesia used for surgical procedures that involves the infusion of a saline solution containing lidocaine, sodium bicarbonate, and epinephrine. This anaesthetic technique is designed to achieve both vasoconstriction and anaesthesia. In this article, we present a modified TLA protocol specifically adapted for reduction mammaplasty, based on an analysis of clinical case histories collected over the past few years. During the period from 2012 to 2022, we performed a reduction mammaplasty procedure in 120 patients employing tumescent local anaesthesia (TLA). The composition of the tumescent solution included 25mL of 2% lidocaine, 8mEq of sodium bicarbonate, and 1mL of epinephrine (1mg/1mL) in 1000mL of 0.9% saline solution. The solution was injected diffusely throughout the mammary gland. The average volume of tumescent solution infiltrated during TLA was 350mL per breast. There were no cases of adrenaline or lidocaine toxicity, and no patients required conversion to general anaesthesia. No patient received sedation. Patients reported no pain or discomfort during pre-operative infiltration or during surgery. No reinterventions were necessary because of short-term complications. Among the complications, there were 4 cases of hematoma (3,3%), 3 cases of seroma (2,55%), 10 cases of wound dehiscence (8,3%), 5 cases of asymmetry (4,1%), 9 cases of T-junction breakdown (7,5%), 2 cases of (partial) nipple necrosis (1,6%), and 3 cases of liponecrosis (2,5%). No cases of infection or total nipple-areola loss were reported. The follow-up period was between 30 days and 1year. Reduction mammaplasty is a viable surgical option for women with macromastia seeking to enhance their physiognomy. It is imperative that patients fully understand the potential benefits and risks associated with the procedure and consult with healthcare professionals specialising in this field. The use of tumescent local anaesthesia (TLA) has been confirmed as a safe and effective methodology to perform reduction mammaplasty, ensuring adequate pain control with minimal post-operative complications and resulting in a high degree of patient satisfaction. 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 .

Impact of connective tissue diseases on complications following aesthetic surgery: A matched cohort study

BackgroundThe association between connective tissue diseases (CTD), including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and scleroderma, and complications following aesthetic surgery is under-investigated. We hypothesized that the risk of complications following aesthetic surgery was higher in patients with these connective tissue disorders compared to matched non-CTD patients. MethodsAll patients diagnosed with RA, SLE and Scleroderma who underwent aesthetic surgery at our institution from 2003-2022 were reviewed. Demographic data, comorbidities, medications, procedures, and postoperative complications were collected. Non-CTD controls were identified for each procedure and matched 1:1 based on propensity scores derived from race, gender, BMI, smoking status, and comorbidities. ResultsSix hundred and thirty-eight patients were included, comprising 319 (50%) patients diagnosed with CTD, and 319 (50%) controls. The average age at surgery was 56.3 years. There were 129 complications. There were no differences between the CTD and non-CTD patients in number of total complications (69 versus 60, p=0.38), major complications (23 versus 16, p=0.25), or minor complications (46 versus 44, p=0.73). Complications were not significantly different between CTD patients and controls who underwent blepharoplasty (p=0.38), breast reduction (p=0.91), abdominoplasty (p=0.46), or rhytidectomy (p=0.50). CTD patients who underwent breast augmentation had significantly more complications compared to matched non-CTD patients on bivariate analysis (7 versus 0, p=0.018*) and multivariable logistic regression (OR: 10.2, 95% CI: 1.21 to 93.3, p=0.039*). ConclusionsMost aesthetic surgeries can safely be performed in patients with connective tissue diseases. Patients seeking breast augmentation should be counselled on a potentially increased risk of post-operative complications.

Variability in Postoperative Nipple Sensation by Dermoglandular Pedicle in Bilateral Breast Reduction

Variability in Postoperative Nipple Sensation by Dermoglandular Pedicle in Bilateral Breast Reduction

The impact of age on outcomes after breast reduction surgery – A multi-institutional data analysis of 40,958 cases

BackgroundReduction mammoplasty is popular among various age groups, yet the impact of age on postoperative outcomes remains debated. MethodsThe ACS-NSQIP (2008-2021) was queried to identify female adult patients who underwent reduction mammoplasty. Patients were categorized into 10-year age brackets (i.e., 18-29, 30-39, 40-49, 50-59, 60-69, and >70 years). We compared age-dependent 30-day outcomes via confounder-adjusted multivariate analyses. Results40,958 female patients (mean age: 41 ± 14 years and mean body mass index: 31 ± 6.1kg/m²) were identified. Complications occurred in 6.4% (n=2,635) of cases, with 770 (1.9%) and 483 (1.2%) patients requiring reoperation and readmission, respectively. 1,706 (4.2%) women experienced surgical complications, while medical complications were generally rare (n=289; 0.7%). Compared to women aged 18-29 years, patients aged 30-39 years (OR: 1.22, p<0.01; OR: 1.05 p=0.51; OR: 1.84, p<0.01), 40-49 years (OR: 1.34, p<0.01; OR: 1.17, p=0.04; OR: 1.54, p=0.03), 50-59 years (OR: 1.45, p<0.01; OR:1.31, p<0.01; OR: 1.78, p<0.01) 60-69 years (OR: 1.38 years, p<0.01; OR: 1.29, p=0.01; OR: 1.71, p<0.01), and >70 years (OR: 1.25, p=0.18; OR: 1.01, p=0.98; OR: 1.86, p=0.14) all had higher risks of any, surgical and medical complications, respectively. Patients aged >30 years were also more likely to require readmissions and reoperations. ConclusionPatient age significantly impacts outcomes after reduction mammoplasty, with the lowest risk in patients under 30 years. Importantly, the association between age and postoperative morbidity was not linear. These findings can help guide informed decisions, recognizing that while age is a factor, it is not the sole determinant of risk.

Pyoderma gangrenosum after breast reduction surgery

Pyoderma gangrenosum after breast reduction surgery

Principle and Logic of Vertical Reduction Repair Double-Ring Breast Reduction.

Secondary reduction mammaplasty poses challenges. This article delves into the reasons and complaints regarding secondary repair following double-ring method and outlines the principle and logic of utilizing vertical incision for repair. A retrospective analysis of patients who underwent secondary reduction mammaplasty in our hospital was conducted. The analysis included baseline demographic data, reasons for consultation, surgical records, and postoperative outcomes. Thirty-five patients (70 breasts) underwent secondary reduction mammaplasty. The mean time between the primary reduction mammaplasty and second procedure was 2.99 years (range, 0.5-15years). The mean weights were 210.49g (range, 42-558g) and 207.91g (range, 6-560g) for left and right mastectomies, respectively. Reasons for secondary reduction mammaplasty include poor shape (flat breasts and pseudoptosis), widened incision scar, persistent macromastia, and bilateral asymmetry. The superior and superomedial vertical techniques are safe, effective, and satisfactory in secondary reduction mammaplasty. 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 .

Timing of Pediatric Breast Reduction and Insurance Coverage: Single-institution Retrospective Study.

Although long-term benefits of reduction mammaplasty have been proven, the appropriate age for adolescent reduction mammaplasty has been highly debated due to possible need for revision surgery. Practitioners often delay offering breast reduction to adolescents below age 18 based on presumed insurance denial. We reviewed trends in insurance denial at a single children's hospital to analyze whether age and/or insurance carriers have a significant impact on coverage of breast reduction. A retrospective chart review from 2012 to 2022 of cisgender female patients with macromastia aged 12-20 years at the time of diagnosis was analyzed for differences in breast reduction insurance coverage based on age and body mass index at the time of diagnosis, referral to plastic surgery, and surgery. A total of 121 cisgender women were included. There were no significant differences in the mean ages of patients who underwent breast reduction versus those who did not (16.46 years versus 16.96 years, respectively; P = 0.089), or in the mean body mass index for patients who did versus those who did not receive breast reduction (28.58 kg/m² versus 29.05kg/m², P = 0.382). Furthermore, there were no significant differences in the proportion of patients undergoing breast reduction by age (P = 0.200) or by insurance class (P = 0.403). Although insurance varies with carrier, the present findings suggest that surgeons need not delay in facilitating preauthorization for breast reduction in symptomatic patients presenting anytime during their teenage years.

The Utility of the Schnur Sliding Scale in Adolescent Patients.

Although the Schnur Sliding Scale (SSS) was not intended to be used by third-party payors, it has become the national standard for coverage decisions regarding macromastia treatment in patients of all ages. Adolescents were neither included in the cohort that created the SSS nor represented in subsequent validation studies. In this prospective study, health-related quality of life surveys were administered to girls and young women 12 to 21 years of age before and after reduction mammaplasty to treat macromastia. The SSS was used preoperatively to estimate the amount of tissue to be resected. Before and after surgery, participants completed the Short Form-36, version 2 (SF-36); the Rosenberg Self-Esteem Scale (RSES); the Breast-Related Symptoms Questionnaire (BRSQ); and the Eating Attitudes Test-26. Demographic data were compared, and linear regressions were used to evaluate the effect of resection amounts meeting the SSS value on survey scores. Resection amounts fell below the SSS for 39 patients and above the SSS for 255 patients. The 2 groups had no differences in mean age or body mass index. Both groups had significant postoperative survey score improvements on the RSES, BRSQ, and 7 of 8 SF-36 domains (all P < 0.05). The groups had comparable postoperative survey scores on the RSES, BRSQ, and 8 of 8 SF-36 domains (all P > 0.05). Adolescents undergoing reduction mammaplasty above and below the SSS experienced comparable physical and psychosocial benefits. These findings underscore the need for third-party payors to broaden coverage for adolescent reduction mammaplasty, as the common coverage cutoff has no effect on overall postoperative benefit. Risk, II.

Incidence of Hematoma Following Breast Reduction in Patients Taking Selective Serotonin Reuptake Inhibitor or Serotonin-Norepinephrine Reuptake Inhibitor: A Retrospective Review.

Background Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is more common in the plastic surgery population compared to the general population. This study was designed to assess the theoretical effect of SSRIs and SNRIs on platelet function and the potential for increased bleeding risk. This study sought to establish the incidence of postoperative bleeding following routine bilateral breast reduction for patients on SSRIs or SNRIs. The outcomes of this study contribute to the discussion of whether these medications should be discontinued before elective surgery. Methodology A retrospective chart review of all patients who received bilateral breast reduction surgery over a 10-year period was performed. Patient charts were reviewed for postoperative hematoma formation as well as medications being used around the time of surgery. The rate of hematoma formation in patients actively taking SSRIs or SNRIs at the time of surgery was compared with the rest of the study population. Results A total of 1,022 patients met the inclusion criteria for the study. The overall incidence of postoperative hematoma was 7.7%. Of these, 1.9% of patients had clinically significant hematomas that required operative evacuation, and the remaining were treated conservatively. The only variable associated with a significantly higher risk of hematoma formation was advanced age (p = 0.005). Conclusions There was no significant difference in hematoma incidence after breast reduction in patients taking SNRIs or SSRIs compared with the general population. This contradicts some of the previously published literature and can hopefully guide clinicians in counseling their patients preoperatively.

Topical Tranexamic Acid Does Not Reduce the Incidence of Hematoma in Reduction Mammoplasty: A Double-Blinded, Randomized Placebo-Controlled Trial.

Topical Tranexamic Acid Does Not Reduce the Incidence of Hematoma in Reduction Mammoplasty: A Double-Blinded, Randomized Placebo-Controlled Trial.

The Use of Recreational Cannabis Among Breast Reduction Patients: Characteristics, Complications, and Immediate Postoperative Analgesic Needs

The Use of Recreational Cannabis Among Breast Reduction Patients: Characteristics, Complications, and Immediate Postoperative Analgesic Needs