Title: Complication rates following immediate breast reconstruction

Biography:

Rafaela Pais Serras is a portuguese Plastic, Reconstructive and Aesthetic resident at Hospital de Sao Jose, Lisbon, Portugal.

Abstract

Objective: To evaluate early complications following mastectomy or conservative breast surgery with immediate reconstruction and identify the associated risk factors.

Methods: From January 2014 to December 2016, 131 female patients underwent immediate breast reconstruction in our department. All patients had a minimum follow-up of one year. Outcomes assessed included age, surgical technique, adjuvant and neoadjuvant therapy, comorbidities, smoking, complications and mortality.

Results: A total of 131 female patients who underwent immediate reconstruction were identified. The overall average age was 51 years (range from 33 to 80 years). Postoperative early complications occurred in 45 of 131 patients (about 34%). The most frequent complication was seroma (49%), followed by wound infection (16%), hematoma (11%), and wound dehiscence (9%) and in a lower percentage skin necrosis, implant exposure, steatonecrosis and lymphedema. Among these patients more than a half have comorbidities associated such as weight excess and obesity (BIM>25kg/m2) at about 36%, active smoking 18%, hypertension 18% and diabetes mellitus type 2 7%. In our study higher complication rates were related to mastectomy followed by tissue expander reconstruction. Other surgical techniques such as oncoplastic surgery with contralateral symmetrization had 40% of complications, latissimus dorsi flap associated with implant 2% and mastectomy with contralateral symmetrization 2%. About 98% underwent adjuvant therapy, mainly hormonotherapy and 22% have received neoadjuvant therapy. Only 1 case registered of metastatic disease and no cases of mortality.

Conclusions: Immediate breast reconstruction is becoming increasingly popular. Our study is consistent with previous studies that indicate breast reconstruction outcomes can be negatively affected by certain patient factors. Smoking, a high BMI, hypertension and diabetes mellitus are all associated with an increase in complications and inferior outcomes. Patient and surgical risk factors should be considered when deciding upon a reconstructive surgery to minimize complication rates and obtain better outcomes.