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. 2021 May 21:29:106-112.
doi: 10.1016/j.jpra.2021.04.006. eCollection 2021 Sep.

Revision Surgery to Improve Cosmesis with Immediate Implant-Based Breast Reconstruction

R Clough  1   2 , L Darragh  1   3 , L Maclennan  1   4 , J M O'Donoghue  1
Affiliations

Revision Surgery to Improve Cosmesis with Immediate Implant-Based Breast Reconstruction

R Clough et al. JPRAS Open. .

Abstract

Background: Following mastectomy for breast cancer, patients may be presented with a range of reconstructive options. The most popular being immediate implant-based reconstruction (IBR).

Objective: To determine the rate of revision surgery to improve cosmesis following IBR.

Design: Retrospective cohort study.

Setting/patients: All patients who underwent IBR at a single UK-based specialist breast reconstructive centre between June 2012 and June 2013.

Measurements: The authors collected data, including demographics, original surgery, revision surgeries and factors likely to influence the cosmetic result.

Results: A total of 88 procedures were included in the study and follow up was performed for a mean duration of 1125 days. In all, 39 breasts required further revision to improve cosmesis to undergo a total of 53 additional procedures. Lipomodelling was the most frequently performed revision (n = 18), whilst implant exchange (n = 16), implant removal (n = 11) and other minor revisions (n = 8) made up the remainder. An early (<3 months) complication, adjuvant radiotherapy and capsular contracture significantly increased the chance of revision surgery (p = 0.018, p = 0.04 and p = 0.009, respectively). Revision surgery added an additional monetary cost of 27.1%-74.1%, which depends on the original procedure performed.

Limitations: The risk of further revision surgery is likely to be higher in those who are followed up for longer periods.

Conclusions: Following immediate IBR, revision surgery represents a substantial burden to the patient including healthcare costs.

Keywords: Immediate Breast Reconstruction; Implants; Mastectomy; Revision surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

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