A Systematic Review of Outcomes and Complications of Tuberous Breast Surgery.

BACKGROUND: Tuberous breast is a complex congenital breast anomaly that can be challenging to correct surgically. OBJECTIVES: The authors conducted a systematic review with pooled analysis of data, with the aim of determining the effectiveness and complications related to operative management of the deformity. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were adopted in performing this systematic review. A simplified classification system for tuberous breast deformity was developed to accurately compare data and guide analysis. RESULTS: The review identified 38 studies, reporting a total of 897 patients undergoing tuberous breast surgery. The mean age of patients was 24 years (range 13-53 years). Mean follow-up was 39 months. A combination of tissue rearrangement and implant augmentation was the most common technique (73% of patients) followed by fat transfer alone (9%). Breast implants were employed in 83% of patients. The mean implanted volume per breast was 263 cc. Fat grafting was performed in 13% of patients and mean volume of fat grafted per breast was 185 cc. An overall complication rate of 20% was reported. Subjective assessment of patient satisfaction was 99%, and the mean score on BREAST-Q for satisfaction with clinical outcome was 86.7. Future studies should focus on robust study designs including randomized and cohort studies, use of patient-reported outcome measures, and long-term follow-up. CONCLUSIONS: The surgical techniques to correct tuberous breast deformity are safe, effective, and have a high satisfaction rate. Fat transfer has the capacity to provide promising results in treating tuberous breast deformity.

A Systematic Review of Efficacy and Complications of High-Definition Liposuction.

BACKGROUND: Traditionally, liposuction is performed on the deeper layer of fat. However, in 1983, Illouz described a liposuction technique targeting the superficial layer of fat. High-definition liposuction (HDL) is an advanced technique of liposuction that generates a desirable profile of anatomical area while promoting skin retraction. Although the safety profile of basic or traditional liposuction has been extensively studied, data relevant to HDL are limited. A systematic review to determine the effectiveness and complications was conducted. METHODS: Across the 21 articles included in the synthesis, a total of 6964 patients underwent HDL procedures. Of the cases where gender was reported, 44% were female patients ( n = 1241) and 56% were male patients ( n = 1556). The average age of patients was 38 years (range, 15 to 76 years) and body mass index was 25 kg/m 2 (range, 18 to 38 kg/m 2 ). RESULTS: An overall complication rate of 14.4% ( n = 994) was calculated, with only 0.2% ( n = 13) of complications classified as major. Transient hyperpigmentation was the most frequently reported complication, affecting 260 patients (3.8%), followed by seroma in 231 (3.3%) and transient soft-tissue fibrosis in 185 (2.7%). Despite an absence of uniform reporting, satisfaction rates of 92.6% ( n = 1497) were reported. CONCLUSIONS: There is a high demand for HDL surgery globally, and this systematic review illustrates the safety and efficacy of HDL. Major complication rates across the entirety of the literature reviewed were 0.2%, with minor complications seen in 14.2% across the 6964 cases reported. High patient satisfaction of 92.6% from HDL procedures was achieved, indicating the efficacy of this procedure.