Complications Of Breast Reduction Research Articles

Shifting the Paradigm on Tissue Removal and Postoperative Complications in Breast Reduction: a Systematic review and Meta-analysis

Shifting the Paradigm on Tissue Removal and Postoperative Complications in Breast Reduction: a Systematic review and Meta-analysis

41. Using the Modified Frailty Index to Predict Complications in Breast Reduction: An Analysis of 14,366 Cases

Purpose: Breast reduction surgery is well-tolerated and has high patient satisfaction, with low risk of surgical site infection and other complications. Breast reduction is among the most commonly performed procedures by plastic surgeons. While age, obesity, and major comorbidities have historically been used as predictors of surgical risk, recent literature now supports frailty measures as a better predictor of surgical risk, such as the modified 5-item frailty index (mFI-5). The authors hypothesized that the mFI-5 is more predictive of 30-day postoperative complications in breast reduction, as compared to other risk proxies. Methods: A retrospective review was performed of all patients from the American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) database who underwent breast reduction without other concurrent procedures, from 2013 to 2019. The mFI-5 and modified Charlson Comorbidity Index (mCCI) scores were calculated for each patient, and complications data were gathered. Age, BMI, number of major comorbidities, ASA class, smoking status, mFI-5 score, and mCCI score were compared as predictors of all-cause 30-day complications, 30-day surgical site complications of any kind, length of stay, and aggregate Clavien-Dindo complication severity score. Univariate logistic and linear regressions and multivariate logistic regression analyses were performed to evaluate predictive value. Results: A total of 14,366 patients were analyzed. The overall complication rate was 5.6%. mFI-5 score significantly predicted all-cause complications, surgical site complications and complication severity, along with ASA class, BMI, smoking status, number of major comorbidities, and age (all p < 0.0001). The strongest predictor for 30-day aggregate complications and surgical site complications was ASA class ≥4. The strongest predictor for an overnight stay was number of major comorbidities, followed closely by mFI-5 score, and ASA class, and BMI. mFI-5 was a superior predictor of complications compared to BMI, age, and smoking status. Multivariable logistic regression found frailty and smoking status were significantly associated independent predictors of 30-day aggregate complications. Conclusions: The mFI-5 is a significant predictor for complications in breast reduction surgery and more significantly associated with complications than common historic risk proxies. While number of major comorbidities are more strongly associated with negative outcomes than mFI-5, the mFI-5 score is a simpler and more reliable tool that can be easily and quickly calculated during a patient consultation to predict complication risk. Surgeons can use the data in the preoperative evaluation of patients requesting breast reduction surgery. Further research is necessary to better understand the predictive value of mFI-5 for breast reduction surgery complications, and also in the context of specific breast reduction outcomes such as reduction weight, usage of drains, usage of perioperative antibiotics, and nipple necrosis.

Commentary on: Using the Modified Frailty Index to Predict Complications in Breast Reduction: A National Surgical Quality Improvement Program Study of 14,160 Cases

Commentary on: Using the Modified Frailty Index to Predict Complications in Breast Reduction: A National Surgical Quality Improvement Program Study of 14,160 Cases

Using the Modified Frailty Index to Predict Complications in Breast Reduction: A National Surgical Quality Improvement Program Study of 14,160 Cases.

Breast reduction is a generally well-tolerated procedure with high patient satisfaction and low risk of surgical site infection and other complications. Although age, obesity, and comorbidities have historically been used as surgical risk proxies, recent literature suggests "frailty" measures, such as the modified 5-item Frailty Index (mFI-5), may be a superior predictor. The aim of this study was to investigate if mFI-5 can predict the likelihood and magnitude of 30-day complications resulting from breast reductions. A retrospective review was performed of the National Surgical Quality Improvement Program (NSQIP) database to assess patients who underwent breast reduction without other concurrent procedures, from 2013 to 2019. mFI-5 scores were calculated for each patient, and complication data were gathered. Age, BMI, number of major comorbidities, American Association of Anesthesiologists class, smoking status, diabetes, steroid use, and mFI-5 score were compared as predictors of all-cause 30-day complications, 30-day surgical site complications of any kind, length of stay, and aggregate Clavien-Dindo complication severity score. Univariate logistic, linear regressions, and multivariate logistic regression analyses were performed to evaluate predictive value. Statistical significance was set at P < 0.05. A total of 14,160 patients were analyzed. The overall complication rate was 5.6%. The mFI-5 score significantly predicted overall 30-day complications, surgical site complications, complication severity, overnight stay, and likelihood of readmission (all P < 0.0001). The mFI-5 is a statistically significant predictor for adverse outcomes in breast reduction surgery. The mFI-5 is a simple and reliable tool that can be efficiently used to conduct a preoperative evaluation of patients requesting breast reductions.

Clinics in Plastic Surgery: Complications in Breast Reduction

Dennis C. Hammond, ed. Clinics in Plastic Surgery: Complications in Breast Reduction . New York, NY: Elsevier, 2016. ISBN-13: 978-0323442831, ISBN-10: 0323442838, $129.00. ![Graphic][1] The April 2016 edition of Clinics in Plastic Surgery is about complications in breast reduction. Dennis Hammond, as editor of this volume of Clinics, needs no introduction and he has gathered a selection of experts who are recognized for their contributions to breast surgery education and literature. The experience of the authors is reflected favorably in the quality of their chapters. The book is set out logically, has 14 chapters with 4 general themes addressed that flow in a progressive manner allowing each successive article to build on the information gleaned from prior topics. The book commences with general considerations such as recognizing risk factors for adverse outcomes detectable in a thorough history and examination. This discussion includes attention to breast cancer screening. We are then drawn into the consideration of general risks and those specific to different surgical techniques that are both aesthetic and related to wound healing. There are sections relating to the management of specific complications and high risk patients including the avoidance of risks rather than simply the management of an established problem. The final chapter is on the medico-legal ramifications of breast reduction surgery which … Corresponding Author : Dr Mark Magnusson, 8 Margaret Street, East Toowoomba, QLD 4350, Australia. E-mail: mark{at}toowoombaplasticsurgery.com.au [1]: /embed/inline-graphic-1.gif

The Use of Dermabrasion to Achieve Natural-Looking Areolas Following Breast Reduction or Mastopexy: A Study of 23 Patients.

Although obtaining symmetrical breasts with good projection and a correctly positioned nipple-areola complex are the main objectives after breast reduction (BR) or mastopexy (MP), the importance of areola esthetics should not be underestimated. In this study, the authors discuss the use of dermabrasion for another purpose, which is to achieve a more natural areola with a smooth, natural border and depigmentation. Twenty-three patients who had undergone BR surgery (18) or MP (5) between 2012 and 2014 were included in the study. The mean age of the participants was 25.5 (range 19-43). Dermabrasion of the areola was performed using a diamond-type fraise to obtain a smooth transition from the border of the areola to the depigmented areola zones. The patients were followed up for 15 months on average (range 12-18 months). In a survey administered 1 year after surgery, the patients were asked to score their new areola on a scale of 0-10. The mean score was 8.6 (range 4-10). Three patients were re-operated due to the persistence of the sharp border due to insufficient dermabrasion. One patient had a hypertrophic scar and another had hyperpigmentation. Satisfactory and a more natural areola can be obtained using dermabrasion with few complications in BR or MP patients. Therefore, this technique may be considered a complementary procedure for motivated and voluntary patients ready to accept the disadvantages of a secondary procedure.

Complications des réductions mammaires à propos de 715 seins

Breast reduction is one of the most frequent operations in elective plastic surgery. The main objective of this study was to describe complications due to breast reduction, and to determine the risk factors.Our comparative retrospective study reviewed the medical files of 715 operated breasts between 2004 and 2009. Statistical analyses were performed with bivariate analyses and multivariable analysis.Smoking, resected mammary gland mass and stretch marks were the three risk factors associated with complications after breast reduction. Smoking was also associated with a high risk of hypertrophics carring. Body-mass index was not associated with a risk of general complications but with a risk of wound dehiscence. The superior pedicle and free nipple graft surgical techniques presented a higher complication rate than the postero-superior and postero-inferior pedicle techniques.These results incite us to postpone and even contraindicate breast reduction surgery in obese and smoking patients. These results also incite us to prefer surgical techniques with optimum security in terms of vascular supply. Complications of breast reduction about 715 breasts.