Complications After Two-Stage Expander Implant Breast Reconstruction Requiring Reoperation

Abstract

Infectious complications including cellulitis and abscess formation accounted for most cases requiring reoperation after TE placement for breast reconstruction. More than a quarter of patients who underwent a reoperation ultimately lost their implants. Patients undergoing two-stage expander implant breast reconstruction should be appropriately counseled regarding the possibility of requiring a reoperation in the setting of developing a complication.

Beyond 30 Days: A Risk Calculator for Longer Term Outcomes of Prosthetic Breast Reconstruction

“…One-year risk of complications in our cohort are comparable to other long-term follow-up values reported in the literature (Table 2). 23–26,50–52 Although these rates are useful as benchmark figures for the population, they have limited utility as risk estimates for most individual patients. That is, the mean incidence of a complication is not representative of most patients, because the distribution of risk is so positively skewed (skewness = 2.027, Fig.…”

“…In the next example, in which this same woman must now undergo radiotherapy, a known factor predisposing her to failure, her risk of explantation almost doubles to 8.8%, a risk multiplier consistent with past reports. 52,53 When further comorbidities are added, the benefits of precision risk calculation become further evident. A BMI of 30 kg/m 2 and smoking status are added in addition to radiotherapy, causing her 1-year risk of explantation to rise to 26% and risk of any complication at all exceeds 40%, which may be sufficient reason for her to consider alternatives such as autologous reconstruction.…”

The use of acellular dermal matrix in breast reconstruction: evolution of techniques over 2 decades

“…Prior to the use of ADMs, effective immediate prosthesis-based breast reconstruction necessitated the use of a submuscular expander with full muscle coverage to improve soft tissue coverage prior to a permanent implant placement or removal of the filling port attached to a combination device (13). The disadvantages of this approach include infectious complications requiring multiple operations (14) and patient discomfort (15).…”

Effect of contralateral augmentation on postoperative complications after the second stage of tissue expander/implant breast reconstruction

“…Several studies have evaluated factors relevant to ischemic complications associated with a mastectomy skin flap, such as mastectomy skin flap necrosis, after breast reconstruction. Established factors include a history of smoking, obesity, mastectomy specimen weight, and radiotherapy (27)(28)(29)(30)(31)(32)(33)(34). Anatomic factors such as skin flap thickness could potentially be associated with ischemic complications but they have rarely been studied.…”