title: Risk Factors Associated With Complication Rates of Becker-Type Expander Implants in Relation to Implant Survival: Review of 314 Implants in 237 Patients.
abstract: Although autologous tissue reconstruction is the best option for breast reconstruction, using implants is still a reliable and simple method, offering acceptable aesthetic results. Becker-type implants are permanent implants that offer a 1-stage reconstructive option. A retrospective study was carried out in our center reviewing the clinical reports of 237 patients, in whom a total of 314 Becker-type prostheses were implanted. Overall survival was calculated using a Kaplan-Meier estimate. Cox proportional hazard models were used to calculate adjusted hazard ratios. At the end of the study, 214 expanders (68.15%) presented no complications, 40 (12.47%) developed significant capsular contracture, in 27 (8.60%) infection occurred, 24 (7.64%) suffered minor complications, and 9 (2.87%) ruptured. The mean survival time of the expanders was 120.41 months (95% CI: 109.62, 131.19). Radiotherapy, chemotherapy, high Molecular Immunology Borstel, age, mastectomy performed previously to the implant, ductal carcinoma, advanced tumoral stage, experience of the surgeon, and Becker 35-type implants were significantly related to a high number of complications in relation to the survival of the implants. Cox regression analysis revealed that the main risk factors for the survival of expander implants included radiotherapy and surgeon experience. The complication hazard ratio or relative risk caused by these 2 factors was 1.976 and 1.680, respectively. One-stage reconstruction using Becker-type expanders is an appropriate, simple, and reliable option in delayed breast reconstruction in patients who have not received radiotherapy and as long as the procedure is carried out by surgeons skilled in the technique.
authors.affiliation: From the *Complexo Hospitalario Universitario of Santiago de Compostela, Santiago de Compostela; †Computer Science Department, Universidad de Vigo, Vigo; and ‡Instituto Gallego de Cirugía Estética, Santiago de Compostela, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Taboada-Suarez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Brea-García
authors.forename: Fernando
authors.initials: F
authors.lastname: Magán-Muñoz
authors.forename: Iván
authors.initials: I
authors.lastname: Couto-González
authors.forename: Eduardo
authors.initials: E
authors.lastname: González-Álvarez
mesh_terms: D000328:Adult; D019928:Breast Implantation / Q000295:instrumentation* / Q000379:methods; D018427:Breast Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008408:Mastectomy; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D016016:Proportional Hazards Models; D011475:Prosthesis Failure / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015625:Tissue Expansion Devices