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Systematic Review and Meta-analysis of Complications Following Mastectomy and Prosthetic Reconstruction in Patients With and Without Prior Breast Augmentation.

Abstract：

BACKGROUND:There is limited evidence available in literature with regard to the complication profile of mastectomy and immediate prosthetic reconstruction in augmented patients. OBJECTIVES:The purpose of this systematic review and meta-analysis is to compare postoperative complications between women with versus without prior augmentation undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction. METHODS:A systematic search was conducted in February 2020 for studies comparing women with versus without prior augmentation undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction with documentation of postoperative complications. Outcomes analyzed included early, late and overall complications. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained through meta-analysis. RESULTS:Our meta-analysis, which included six studies comparing 241 breasts with prior augmentation and 1441 without, demonstrated no significant difference between the two groups in rates of early (36.7% vs. 24.8%; OR=1.57, 95% CI 0.94 to 2.64; P=0.09), late (10.1% vs. 19.9%; OR=0.53, 95% CI 0.06 to 4.89; P=0.57) and overall complications (36.5% vs. 31.2%; OR=1.23, 95% CI 0.76 to 2.00; P=0.40). Subgroup analysis showed a significantly higher rate of hematoma formation in the augmented group (3.39% versus 2.15%; OR=2.68, 95% CI 1.00 to 7.16; P=0.05), but no difference in rates of seroma, infection, mastectomy skin flap necrosis and prosthesis loss. CONCLUSIONS:Our meta-analysis suggests that prior augmentation does not significantly increase overall postoperative complications in women undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction. However, the significantly higher rate of hematoma formation in augmented patients warrants further investigation and preoperative discussion.

journal_name

Aesthet Surg J

journal_title

Aesthetic surgery journal

authors

Chicco M,Ahmadi AR,Cheng HT

doi

10.1093/asj/sjab028

subject

Has Abstract

pub_date

2021-01-22 00:00:00

eissn

1090-820X

issn

1527-330X

pii

6106934

pub_type

杂志文章

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Systematic Review and Meta-analysis of Complications Following Mastectomy and Prosthetic Reconstruction in Patients With and Without Prior Breast Augmentation.