Implant-based immediate breast reconstruction in the previously augmented patient.
BACKGROUND
Millions of women have undergone augmentation mammaplasty with implants and breast cancer continuing to be the most common non-cutaneous malignancy in female patients. Reconstructive surgeons will inevitably encounter breast cancer patients with prior augmentation. Implant-based techniques represent the most common form of breast reconstruction overall and remains a common option among those who were previously augmented.


OBJECTIVE
The purpose of this study is to evaluate outcomes of implant-based reconstruction in previously augmented women.


METHODS
A retrospective review from September 2004 to December 2009 was performed. 38 women (63 breasts) with a history of prior augmentation (PA) who underwent implant-based reconstruction were identified and compared to a non-prior augmented (NPA) control group (77 patients; 138 breasts). Normative data, augmentation details, reconstruction method, complication rates, and revision rates were evaluated.


RESULTS
The total complication rate was significantly different between the two groups with 18 complications (28.6%) occurring in 9 PA breasts and 20 complications (14.5%) in 19 NPA breasts (p-value 0.037). When analyzed by specific complication subtypes, capsular contracture was the only complication that bordered significance between the two cohorts (p-value 0.057). Complication rates were otherwise similar regardless of augmentation or reconstruction type.


CONCLUSIONS
Implant-based reconstruction is a safe option for previously augmented patients that is able to provide outcomes similar to non-augmented patients. Results are not affected by the location of previous implants or the implant-based reconstruction method. There may be a higher incidence of capsular contracture in the previously augmented patient that warrants further investigation and preoperative discussion.
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA. Electronic address: jasonroostaeian@mednet.ucla.edu.
Jason
J
Roostaeian
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Alfred P
AP
Yoon
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Paymon
P
Rahgozar
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Neil
N
Tanna
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Christopher A
CA
Crisera
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Andrew L
AL
Da Lio
University of California Los Angeles, Division of Plastic & Reconstructive Surgery, Los Angeles, CA 90095, USA.
Jaco H
JH
Festekjian
D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies
Breast implants; Breast reconstruction; Capsular contracture; Previously augmented; Prior augmented