Comparative Outcomes of Superomedial and Inferior Pedicles in Breast Reduction and Mastopexy: A Meta-Analysis of 5123 Breasts.

[BACKGROUND] Superomedial and inferior pedicles are two commonly used techniques in breast reduction and mastopexy. This systematic review and meta-analysis aims to compare the clinical outcomes associated with these two techniques.

[METHODS] PubMed, Scopus, and Web of Science were searched for relevant studies. We included all studies with data comparing superomedial and inferior pedicles. Statistical analyses were performed using RevMan version 5.4.

[RESULTS] The search yielded 1075 studies, of which 15 were included in the meta-analysis, encompassing 2633 patients (5123 breasts), with 3491 breasts receiving superomedial pedicles and 1632 breasts receiving inferior pedicles. Superomedial pedicles were associated with significantly shorter operative length (MD = - 24.71, 95% CI = - 37.63 to - 11.79, p = 0.0002), higher BREAST-Q breast satisfaction scores (MD = 10.34, 95% CI = 7.72 to 12.96, p < 0.00001), lower infection rates (RR = 0.46, 95% CI = 0.24 to 0.86, p = 0.02), higher incidence of seroma (RR = 3.00, 95% CI = 1.15 to 7.79, p = 0.02), and higher incidence of decreased nipple-areola complex (NAC) sensation (RR = 1.50, 95% CI = 1.12 to 2.01, p = 0.006). No significant differences were observed in asymmetry, fat necrosis, NAC loss, and hematoma.

[CONCLUSION] Superomedial pedicles demonstrated higher incidences of decreased NAC sensation and seroma formation, lower incidence of infection, shorter operative length, and higher BREAST-Q breast satisfaction scores compared to inferior pedicles. Further research is needed to confirm these findings and explore the long-term aesthetic outcomes associated with both techniques.

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