Secondary reduction mammaplasty techniques and outcomes: Cleveland Clinic experience.

Breast Complications Mammaplasty Pedicle Reduction Secondary reduction

Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
26 Jul 2024
Historique:
received: 30 05 2024
revised: 12 07 2024
accepted: 22 07 2024
medline: 17 8 2024
pubmed: 17 8 2024
entrez: 16 8 2024
Statut: aheadofprint

Résumé

Information on optimal techniques and outcomes following secondary reduction mammaplasty remains sparse, with only 280 patient cases reported in the literature to date. A total of 7179 medical charts of patients who underwent nononcological breast reduction at the Cleveland Clinic Health System from January 2001 to October 2023 were screened to identify whether the procedure was a secondary reduction. Patient charts were then reviewed to extract demographic, surgical, and outcome data. Patients were also contacted through the electronic medical record to fill out the BREAST-Q V2 questionnaire about postoperative satisfaction. Surgical techniques and satisfaction were compared for patients with complications versus those without. One hundred and twenty-two (1.7%) patients underwent secondary breast reduction. An inferior pedicle was the most used for both primary (n = 59, 48.4%) and secondary (n = 64, 52.5%) surgeries. The primary pedicle was recreated in 62 of the 84 (73.8%) rereductions where a primary pedicle was known. A total of 15 patients (12.3%) completed the BREAST-Q questionnaire. Body mass index was significantly and negatively associated with satisfaction with outcome (R=-0.66, p = 0.01), sexual well-being (R=-0.58, p = 0.04), and physical well-being (R=-0.69, p = 0.006). No patients experienced nipple-areola complex (NAC) necrosis following secondary reduction. However, 21 (17.2%) of patients experienced complications or breast fat necrosis following rereduction. Unmatched secondary pedicles showed a trend toward higher complication rates than matched secondary pedicles (31.3% vs. 12.9%, p = 0.051). When known, the primary pedicle can be safely used for secondary reduction mammaplasty with minimal risk of NAC necrosis or complication.

Sections du résumé

BACKGROUND BACKGROUND
Information on optimal techniques and outcomes following secondary reduction mammaplasty remains sparse, with only 280 patient cases reported in the literature to date.
METHODS METHODS
A total of 7179 medical charts of patients who underwent nononcological breast reduction at the Cleveland Clinic Health System from January 2001 to October 2023 were screened to identify whether the procedure was a secondary reduction. Patient charts were then reviewed to extract demographic, surgical, and outcome data. Patients were also contacted through the electronic medical record to fill out the BREAST-Q V2 questionnaire about postoperative satisfaction. Surgical techniques and satisfaction were compared for patients with complications versus those without.
RESULTS RESULTS
One hundred and twenty-two (1.7%) patients underwent secondary breast reduction. An inferior pedicle was the most used for both primary (n = 59, 48.4%) and secondary (n = 64, 52.5%) surgeries. The primary pedicle was recreated in 62 of the 84 (73.8%) rereductions where a primary pedicle was known. A total of 15 patients (12.3%) completed the BREAST-Q questionnaire. Body mass index was significantly and negatively associated with satisfaction with outcome (R=-0.66, p = 0.01), sexual well-being (R=-0.58, p = 0.04), and physical well-being (R=-0.69, p = 0.006). No patients experienced nipple-areola complex (NAC) necrosis following secondary reduction. However, 21 (17.2%) of patients experienced complications or breast fat necrosis following rereduction. Unmatched secondary pedicles showed a trend toward higher complication rates than matched secondary pedicles (31.3% vs. 12.9%, p = 0.051).
CONCLUSION CONCLUSIONS
When known, the primary pedicle can be safely used for secondary reduction mammaplasty with minimal risk of NAC necrosis or complication.

Identifiants

DOI: 10.1016/j.bjps.2024.07.057 PMID: 39151285
pubmed: 39151285
pii: S1748-6815(24)00418-2
doi: 10.1016/j.bjps.2024.07.057
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

138-146

Informations de copyright

Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Auteurs

Eliot N Haddad (EN)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

Rommy Obeid (R)

Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Riley Marlar (R)

Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Fuad Abbas (F)

Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Joseph Quick (J)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

Aleksandar Izda (A)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

Raymond Isakov (R)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA; Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Steven Bernard (S)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA; Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Graham Schwarz (G)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA; Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Risal Djohan (R)

Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Bahar Bassiri Gharb (BB)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA; Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA.

Antonio Rampazzo (A)

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA; Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA. Electronic address: rampaza@ccf.org.

Classifications MeSH