Shifting the paradigm on tissue removal and postoperative complications in breast reduction: A systematic review and meta-analysis.

Abstract

The amount of tissue resection, measured in weight per breast, in breast reduction surgery has been considered a potential risk factor for complications. We aimed to evaluate the effect of removing >1000 g versus <1000 g of breast tissue in women with macromastia. A systematic search was performed on Pubmed, Embase, and Cochrane in March 2024 for studies that compared resection weight >1000 g versus <1000 g in reduction mammoplasty. Pooled odds ratios were computed for binary endpoints. We used R Studio for statistical analysis. We included 8 studies, with 1760 breasts, among which 493 (28.1%) had resection of ≥1000 g per breast. Women who had >1000 g of tissue resected per breast had lower risk of developing hypertrophic scar (OR 0.07; 95% CI 0.02-0.25; p < 0.001) and surgical site infection (OR 0.17, 95% CI 0.07-0.42, p < 0.001) than those who had <1000 g of breast resection. No statistical difference was observed among the groups for the outcomes of delayed wound healing and dehiscence, hematoma, fat or areolar necrosis, overall complications rates, and seroma. Among women who underwent reduction mammoplasty, resection of >1000 g of tissue per breast was associated with lower risk of hypertrophic scar development and surgical site infection than resection of <1000 g.