Impact of connective tissue diseases on complications following aesthetic surgery: A matched cohort study

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Abstract

Background

The association between connective tissue diseases (CTDs), including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and scleroderma, and complications following aesthetic surgery is under-investigated. We hypothesized that the risk of complications following aesthetic surgery was higher in patients with these connective tissue disorders compared to matched non-CTD patients.

Methods

All patients diagnosed with RA, SLE, and scleroderma who underwent aesthetic surgery at our institution from 2003–2022 were reviewed. Demographic data, comorbidities, medications, procedures, and postoperative complications were collected. Non-CTD controls were identified for each procedure and matched 1:1 based on propensity scores derived from race, sex, body mass index, smoking status, and comorbidities.

Results

Six hundred 38 patients were included, comprising 319 (50%) patients diagnosed with CTD and 319 (50%) controls. The average age at surgery was 56.3 years. There were 129 complications. There were no differences between the CTD and non-CTD patients in number of total complications (69 versus 60, p = 0.38), major complications (23 versus 16, p = 0.25), or minor complications (46 versus 44, p = 0.73). Complications were not significantly different between CTD patients and controls who underwent blepharoplasty (p = 0.38), breast reduction (p = 0.91), abdominoplasty (p = 0.46), or rhytidectomy (p = 0.50). CTD patients who underwent breast augmentation had significantly more complications than matched non-CTD patients in bivariate analysis (7 versus 0, p = 0.018*) and multivariable logistic regression (OR: 10.2, 95% CI: 1.21 to 93.3, p = 0.039*).

Conclusions

Most aesthetic surgeries can safely be performed in patients with CTDs. Patients seeking breast augmentation should be counseled on a potentially increased risk of postoperative complications.
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结缔组织疾病对美容手术并发症的影响:匹配队列研究
背景结缔组织疾病(CTD),包括类风湿性关节炎(RA)、系统性红斑狼疮(SLE)和硬皮病,与美容手术后并发症之间的关系尚未得到充分研究。我们假设,与匹配的非结缔组织疾病患者相比,这些结缔组织疾病患者在美容手术后出现并发症的风险更高。方法回顾了 2003-2022 年期间在本院接受美容手术的所有确诊为 RA、系统性红斑狼疮和硬皮病的患者。收集了人口统计学数据、合并症、药物、手术和术后并发症。根据种族、性别、体重指数、吸烟状况和合并症得出的倾向分数,为每项手术确定了非 CTD 对照组,并进行了 1:1 匹配。手术时的平均年龄为 56.3 岁。共有 129 例并发症。CTD 和非 CTD 患者在总并发症数量(69 对 60,P = 0.38)、主要并发症(23 对 16,P = 0.25)或轻微并发症(46 对 44,P = 0.73)方面没有差异。接受眼睑成形术(p = 0.38)、乳房缩小术(p = 0.91)、腹部成形术(p = 0.46)或韵律切除术(p = 0.50)的 CTD 患者与对照组的并发症无明显差异。在双变量分析(7 对 0,p = 0.018*)和多变量逻辑回归(OR:10.2,95% CI:1.21 至 93.3,p = 0.039*)中,接受隆胸手术的 CTD 患者的并发症明显多于匹配的非 CTD 患者。结论大多数美容手术都可以安全地在 CTD 患者中进行,但应告知寻求隆胸的患者术后并发症的风险可能会增加。
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来源期刊
CiteScore
3.10
自引率
11.10%
发文量
578
审稿时长
3.5 months
期刊介绍: JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.
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