Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jun;121(6):1886-1892.
doi: 10.1097/PRS.0b013e31817151c4.

Predicting complications following expander/implant breast reconstruction: an outcomes analysis based on preoperative clinical risk

Colleen M McCarthy  1 , Babak J Mehrara, Elyn Riedel, Kristen Davidge, Akili Hinson, Joseph J Disa, Peter G Cordeiro, Andrea L Pusic
Affiliations

Predicting complications following expander/implant breast reconstruction: an outcomes analysis based on preoperative clinical risk

Colleen M McCarthy et al. Plast Reconstr Surg. 2008 Jun.

Abstract

Background: Complications following postmastectomy reconstruction can cause significant morbidity. The compound effect of individual risk factors on the development of complications following expander/implant reconstruction has not, however, been well delineated. This study evaluated the impact of clinical risk factors to predict complications following postmastectomy expander/implant reconstruction.

Methods: From 2003 through 2004, 1170 expander/implant reconstructions were performed at a single center. A prospectively maintained database was reviewed. Variables including age, smoking status, body mass index, history of diabetes, hypertension, chemotherapy and/or radiation, as well as timing and laterality of reconstruction were evaluated. The primary endpoint was the development of a complication; the secondary endpoint was failure of reconstruction.

Results: Over the 2 year study period, 1170 expander/implant reconstructions were performed in 884 patients. The odds of developing complications was 2.2 times greater in smokers (p < 0.001) and 2.5 times greater in women over 65 (p = 0.008). Patients who were obese were at nearly two times the odds of having complications (p = 0.02), as were patients with hypertension (p = 0.02). Similarly, the odds of reconstructive failure were five times greater in smokers (p < 0.001). Age was not a significant predictor of reconstructive failure (p = 0.09); yet, failure was nearly seven times greater in obese patients (p < 0.001), and four more times likely in those who were hypertensive (p = 0.005).

Conclusions: Smoking, obesity, hypertension, and age over 65 were independent risk factors for perioperative complications following expander/implant breast reconstruction. Smoking, obesity, and hypertension were similarly associated with reconstructive failure. This information can be used to evaluate overall procedural risks and individualize reconstructive options.

PubMed Disclaimer

References

    1. Gebski, V., Lagleva, M., Keech, A., Simes, J., and Langlands, A. O. Survival effects of postmastectomy adjuvant radiation therapy using biologically equivalent doses: A clinical perspective. J. Natl. Cancer Inst. 98: 26, 2006.
    1. Armstrong, R. W., Berkowitz, R. L., and Bolding, F. Infection following breast reconstruction. Ann. Plast. Surg. 23: 284, 1989.
    1. August, D. A., Wilkins, E., and Rea, T. Breast reconstruction in older women. Surgery 115: 663, 1994.
    1. Alderman, A., and Wilkins, E. Complications in postmastectomy breast reconstruction: Two-year results of the Michigan Breast Reconstruction Outcome Study. Plast. Reconstr. Surg. 109: 2265, 2002.
    1. Padubidri, A. N., Yetman, R., Browne, E., et al. Complications of postmastectomy breast reconstruction in smokers, ex-smokers, and nonsmokers. Plast. Reconstr. Surg. 107: 350, 2001.

MeSH terms