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 Jul;122(1):19-28.
doi: 10.1097/PRS.0b013e3181774267.

True incidence of all complications following immediate and delayed breast reconstruction

Stephen R Sullivan  1 , Derek R D Fletcher, Casey D Isom, F Frank Isik
Affiliations

True incidence of all complications following immediate and delayed breast reconstruction

Stephen R Sullivan et al. Plast Reconstr Surg. 2008 Jul.

Abstract

Background: Improved self-image and psychological well-being after breast reconstruction are well documented. To determine methods that optimized results with minimal morbidity, the authors examined their results and complications based on reconstruction method and timing.

Methods: The authors reviewed all breast reconstructions after mastectomy for breast cancer performed under the supervision of a single surgeon over a 6-year period at a tertiary referral center. Reconstruction method and timing, patient characteristics, and complication rates were reviewed.

Results: Reconstruction was performed on 240 consecutive women (94 bilateral and 146 unilateral; 334 total reconstructions). Reconstruction timing was evenly split between immediate (n = 167) and delayed (n = 167). Autologous tissue (n = 192) was more common than tissue expander/implant reconstruction (n = 142), and the free deep inferior epigastric perforator was the most common free flap (n = 124). The authors found no difference in the complication incidence with autologous reconstruction, whether performed immediately or delayed. However, there was a significantly higher complication rate following immediate placement of a tissue expander when compared with delayed reconstruction (p = 0.008). Capsular contracture was a significantly more common late complication following immediate (40.4 percent) versus delayed (17.0 percent) reconstruction (p < 0.001; odds ratio, 5.2; 95 percent confidence interval, 2.3 to 11.6).

Conclusions: Autologous reconstruction can be performed immediately or delayed, with optimal aesthetic outcome and low flap loss risk. However, the overall complication and capsular contracture incidence following immediate tissue expander/implant reconstruction was much higher than when performed delayed. Thus, tissue expander placement at the time of mastectomy may not necessarily save the patient an extra operation and may compromise the final aesthetic outcome.

PubMed Disclaimer

References

    1. Jemal, A., Siegel, R., Ward, E., et al. Cancer statistics, 2006. CA Cancer J. Clin. 56: 106, 2006.
    1. Bostwick, J., III, and Carlson, G. W. Reconstruction of the breast. Surg. Oncol. Clin. North Am. 6: 71, 1997.
    1. Overgaard, M., Hansen, P. S., Overgaard, J., et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N. Engl. J. Med. 337: 949, 1997.
    1. Ragaz, J., Jackson, S. M., Le, N., et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N. Engl. J. Med. 337: 956, 1997.
    1. Alderman, A. K., and Wilkins, E. G. Radiation therapy in postmastectomy TRAM reconstruction. Plast. Reconstr. Surg. 109: 1199, 2002.