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Open AccessArticle

Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population

1
Division of Plastic Surgery, Mayo Clinic, Rochester, MN 55904, USA
2
Department of Surgery, Mayo Clinic, Rochester, MN 55904, USA
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(8), 481; https://doi.org/10.3390/medicina55080481
Received: 23 May 2019 / Revised: 18 July 2019 / Accepted: 12 August 2019 / Published: 14 August 2019
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PDF [294 KB, uploaded 14 August 2019]

Abstract

Background and objectives: Differences in patient anatomy and physiology exist between young and older patients undergoing breast reconstruction after mastectomy. Breast cancer has been described as being more aggressive, more likely to receive radiation, contralateral mastectomy, as well as bilateral reconstruction in young patients. Our purpose is to report long-term experience on two-staged implant-based breast reconstruction (IBR) in young females, with complication sub-analysis based on obesity and adjuvant radiation. Materials and Methods: Retrospective chart review of all consecutive young patients who underwent two-staged IBR at our institution, between 2000 and 2016, was performed. Patients between 15 and 40 years old with least 1-year follow-up were included. Univariate logistic regression models and receiver operating characteristic (ROC) curves were created. Results: Overall 594 breasts met our inclusion criteria. The mean age was 34 years, and the median follow-up was 29.6 months. Final IBR was achieved in 98% of breasts. Overall, 12% of breasts had complications, leading to explantations of 5% of the devices. Adjuvant radiation was followed by higher rates of total device explantations (p = 0.003), while obese patients had higher rates of total complications (p < 0.001). For each point increase in BMI, the odds of developing complications increased 8.1% (p < 0.001); the cutoff BMI to predict higher complications was 24.81 kg/m2. Conclusions: This population demonstrates high successful IBR completion and low explantation rates. These data suggest that obese women and those with planned adjuvant radiation deserve special counseling about their higher risk of complications. View Full-Text
Keywords: implants-based breast reconstruction; young females; reconstructive outcome; adjuvant radiation; obesity implants-based breast reconstruction; young females; reconstructive outcome; adjuvant radiation; obesity
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Manrique, O.J.; Charafeddine, A.; Abu-Ghname, A.; Banuelos, J.; Jacobson, S.R.; Martinez-Jorge, J.; Nguyen, M.-D.; Harless, C.; Tran, N.V.; Sharaf, B.; Jakub, J.W.; Hieken, T.J.; Degnim, A.C.; Boughey, J.C. Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population. Medicina 2019, 55, 481.

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