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Outcomes Of Superomedial Pedicle Breast Reduction: Systematic Review And Meta-analysis
Osama Darras, MD, PhD(c), Adam Ghazoul, BS, Bryce Bemper, BS, Sean Frisbie, BS, Raffi Gurunian, MD, PhD, Sarah N. Bishop, MD.
Cleveland Clinic Foundation, Cleveland, OH, USA.

PURPOSE:
Recently, superomedial pedicle breast reduction, combined with wise-pattern or vertical skin resection, has gained popularity. This systematic review investigated how different types of skin resection impact complication rates in these procedures.
METHODS:
PRISMA guidelines was followed to analyze studies on breast reduction and complications using SPSS. Our search included terms related to 'breast reduction' and 'complications.' We examined outcomes such as areolar necrosis, infection, wound dehiscence, hypertrophic scarring, altered sensibility, seroma, hematoma, fat necrosis, dog ear deformities, and delayed healing. We also considered variables like BMI, excised tissue mass, and patient age.
RESULTS:
332 papers underwent abstract screening, and 90 underwent full-text screening. 54 studies were extracted to yield 12,493 breasts in 6,458 patients. Analysis showed a significant weak correlation between the age of patients and the incidence of post-operative complications (p<0.001). There was also a correlation between the mass of tissue excised and BMI and the incidence of post-operative complications was negligible however significant (p<0.001). The incidence of complications with vertical scar closure was significantly higher than wise-pattern closure (p<0.001). Subgroup analysis reported in Figure 1.
CONCLUSION:
Older age was linked to a significantly higher risk of complications in superomedial pedicle breast reductions. Vertical skin closure presented more notable complications than wise-pattern closures; however, it resulted in less wound dehiscence, delayed healing, and altered sensation.

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