2017年九月 Aesthetic Plastic Surgery 論文
Capsular Contracture Rate After Breast Augmentation with Periareolar Versus Other Two (Inframammary and Transaxillary) Incisions: A Meta-Analysis
BACKGROUND:
Capsular contracture has been the most common complication of cosmetic breast augmentation. The effect of incision pattern on capsular contracture is still unclear. This meta-analysis demonstrates current evidence with regard to the comparison of capsular contracture rate between periareolar and other two (transaxillary and inframammary) incisions.
METHODS:
PubMed, EMBASE, and Cochrane databases were searched up to January 2017. The results of selected studies were meta-analyzed to obtain a pooled odds ratio of the effect of periareolar versus other two incision patterns (transaxillary or inframammary incision) of breast augmentation on capsular contracture rates. In addition, subgroup analyses were performed on periareolar versus transaxillary groups and periareolar versus inframammary groups with regard to capsular contracture rate.
RESULTS:
Seven comparative studies were selected and meta-analyzed. Five of the seven studies reported a higher rate of capsular contracture on patients with periareolar incisions. The results showed a significantly higher rate of capsular contracture with periareolar incisions compared with other two incisions (OR, 1.83; 95% CI, 1.06-3.15, p = 0.03). Subgroup results showed no significant difference of capsular contracture between periareolar incisions and transaxillary incisions (OR, 0.94; 95% CI, 0.52-1.64, p = 0.79) and showed a significantly higher rate of capsular contracture in periareolar incisions compared to inframammary incisions (OR, 1.91; 95% CI, 1.06-3.43, p = 0.03).
CONCLUSION:
The results of this meta-analysis demonstrate the contributing effects of periareolar breastaugmentation on the rate of capsular contracture. However, more studies with longer tracking periods and higher quality should be conducted to further verify this conclusion.
Capsular contracture has been the most common complication of cosmetic breast augmentation. The effect of incision pattern on capsular contracture is still unclear. This meta-analysis demonstrates current evidence with regard to the comparison of capsular contracture rate between periareolar and other two (transaxillary and inframammary) incisions.
METHODS:
PubMed, EMBASE, and Cochrane databases were searched up to January 2017. The results of selected studies were meta-analyzed to obtain a pooled odds ratio of the effect of periareolar versus other two incision patterns (transaxillary or inframammary incision) of breast augmentation on capsular contracture rates. In addition, subgroup analyses were performed on periareolar versus transaxillary groups and periareolar versus inframammary groups with regard to capsular contracture rate.
RESULTS:
Seven comparative studies were selected and meta-analyzed. Five of the seven studies reported a higher rate of capsular contracture on patients with periareolar incisions. The results showed a significantly higher rate of capsular contracture with periareolar incisions compared with other two incisions (OR, 1.83; 95% CI, 1.06-3.15, p = 0.03). Subgroup results showed no significant difference of capsular contracture between periareolar incisions and transaxillary incisions (OR, 0.94; 95% CI, 0.52-1.64, p = 0.79) and showed a significantly higher rate of capsular contracture in periareolar incisions compared to inframammary incisions (OR, 1.91; 95% CI, 1.06-3.43, p = 0.03).
CONCLUSION:
The results of this meta-analysis demonstrate the contributing effects of periareolar breastaugmentation on the rate of capsular contracture. However, more studies with longer tracking periods and higher quality should be conducted to further verify this conclusion.
中文簡譯導讀
此篇論文篇名為：Capsular Contracture Rate After Breast Augmentation with Periareolar Versus Other Two (Inframammary and Transaxillary) Incisions: A Meta-Analysis. 刊登在Aesthetic Plastic Surgery，主旨在討論不同切口(乳暈旁，腋下與胸下緣切口)在隆乳手術時的莢膜攣縮比例。是一篇大規模的統計 meta-analysis，統計了七個比較性的研究(comparative study)，結果發現在這七個比較性研究中，有五個指出乳暈切口有較高的莢膜攣縮比例，整體而言，乳暈切口隆乳比其他切口隆乳(腋下與胸下緣)有較高的莢膜攣縮比例(Odds Ratio, 1.83, p=0.03)。而進一步的次分類分析則發現：
- 乳暈隆乳與腋下隆乳的莢膜攣縮比例無明顯差異 (Odds Ratio, 0.94, p=0.79)
- 乳暈隆乳比胸下緣隆乳有較高的莢膜攣縮比例 (Odds Ratio, 1.91, p=0.03)
吳至偉醫師經驗
隆乳術後的莢膜攣縮，讓許多醫師與女性朋友困擾，以目前的研究來說，以非乳暈的的切口，使用絨毛面果凍矽膠，將果凍矽膠放在胸大肌下，可以得到最低的莢膜攣縮比例，而這也是吳至偉醫師目前的隆乳常規使用方式。
延伸閱讀
