Meta-analysis Of The Application Of Subglandular And Submuscular Implantation In Primary Breast Augmentation

Objective:A meta-analysis was conducted to systematically compare the efficacy and complication rate of subglandular and submuscular implantation in primary breast augmentation.Methods:Use computer to search literature in Cnki,Wanfang Database,VIP database,Pubmed,Cochrane Library,Embase and other databases with the keywords "breast augmentation","implant","submuscular","subglandular".The literature on the comparison of subglandular and submuscular implantation in primary breast augmentation was retrieved from the self-established database until December 31,2022.The two groups were subglandular(SG)group and submuscular(SM)group.The included literature was reviewed,screened and data extracted by Endnote20 software.Finally,the software Review Manager5.4 was used to carry out statistical analysis on the data in the included literature,such as the patient satisfaction rate,the rate of reoperation and the incidence of complications such as capsular contracture,hematoma and infection.Results:A total of 401 literatures were retrieved.After review,preliminary screening of literature titles and abstracts and reading the full text,16 clinical studies were finally included in quantitative analysis,and all literatures were divided into SG group and SM group.After meta-analysis of the above literatures,it was concluded that there was no statistically significant difference in satisfaction rate between the SG group and the SM group(OR=1.56;95%CI=0.49～4.90;P=0.45 > 0.05);There was no significant difference in the rate of reoperation between the SG and SM groups(OR=1.10;95%CI=0.78～1.56;P=0.58 > 0.05);SG group had a higher incidence of capsular contracture than SM group(OR=2.85;95%CI= 2.45-3.32;P < 0.00001);There was no significant difference in the incidence of postoperative implant infection between SG group and SM group(OR=0.45;95%CI= 0.17-0.22;P=0.12 > 0.05);There was no significant difference in the incidence of postoperative hematoma between SG group and SM group(OR=1.25;95%CI=0.82-1.90;P=0.30 > 0.05);There was no significant difference in the incidence of postoperative implant displacement between SG and SM groups(OR=0.43;95%CI=0.18～1.07;P=0.07 > 0.05);There was no significant difference in the incidence of implant rupture between SG group and SM group(OR=0.92;95%CI=0.29～2.92;P=0.88 > 0.05);The incidence of implant contour development was higher in SG group than SM group(OR=2.92;95%CI=1.57～5.42;P=0.0007 < 0.05);SG group had a higher incidence of postoperative papillary areolar hypoesthesia than SM group(OR=2.42;95%CI=1.08～5,42;P=0.03 < 0.05).Conclusion:Compared with breast augmentation with implants at the submuscular plane,the postoperative capsular contracture rate,the incidence of implant contour development and the incidence of papillary areolar hypoesthesia were higher in breast augmentation with implants at the subglandular plane,but there was no significant difference in patient satisfaction rate,the incidence of postoperative prosthesis infection,postoperative hematoma,the incidence of prosthesis displacement and the incidence of prosthesis rupture.