title: Outcome analysis of immediate and delayed conservative breast surgery reconstruction with mastopexy and reduction mammaplasty techniques.
abstract: BACKGROUND
  Bilateral mammaplasty or mastopexy is frequently used for oncoplastic objectives. However, little information has been available regarding outcome following immediate and delayed reconstruction.
  
  
  METHODS
  Patients were divided into Group I (immediate reconstruction) and Group II (delayed reconstruction). Retrospective review was performed to compare complications, length of hospital stay, revision surgeries, and satisfaction. The associations between the complications with potential risk factors (timing, age, body mass index, smoking, and comorbid medical conditions) were analyzed.
  
  
  RESULTS
  There were a total of 144 patients with a mean follow-up of 47 months. Of the 106 patients in Group I, complications occurred in 24 (22.6%), skin necrosis was observed in 7.5%, fat necrosis in 5.6%, and 6.6% patients developed local recurrence. Mean period of hospitalization was 1.89 days. Of the 38 patients of the Group II, complications occurred in 12 (31.5%), skin necrosis was observed in 7 (18.4%), fat necrosis in 4 (10.5%), and 5.2% patients developed local recurrence. Mean period of hospitalization was 1.35 days. Increased length of hospital stay greater than 1 day (P < 0.001) and the number of revision surgeries (P = 0.043) were associated with the timing of the reconstruction. In univariate analysis, no difference between groups was found with respect to complication incidence (P = 0.275); however, after adjusting for other risk factors, the probability of complications tend to be higher for Group II (OR = 2.65; 95% confidence interval = 1.01-7.00; P = 0.049).
  
  
  CONCLUSIONS
  On the basis of the results of our study, the probability of complications tends to be higher for delayed reconstructions, and it is demonstrated that obesity and smoking are risk factors for complications. Ultimately, these data may facilitate the provision of individualized risk information for shared medical decision-making.
authors.affiliation: Division of Plastic Surgery, University of São Paulo School of Medicine, São Paulo, Brazil. munhozalex@uol.com.br
authors.forename: Alexandre Mendonça
authors.initials: AM
authors.lastname: Munhoz
authors.forename: Cláudia Maria
authors.initials: CM
authors.lastname: Aldrighi
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montag
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arruda
authors.forename: José Augusto
authors.initials: JA
authors.lastname: Brasil
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Filassi
authors.forename: José Mendes
authors.initials: JM
authors.lastname: Aldrighi
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors