Unplanned revisional surgery for cosmesis following immediate implant based reconstruction
Association of Breast Surgery ePoster Library. Clough R. 05/15/17; 166274; P053
Mr. Richard Clough
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Abstract
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Introduction
Increasingly reconstruction following mastectomy is carried out as an immediate procedure. Reconstruction options are varied and a collaborative approach between clinicians and patients is required. Patients are generally advised that implant based reconstructions may require maintenance surgery in the future. This study aimed to quantify how many patients required unplanned surgery to improve cosmesis, following successful immediate implant based reconstruction in the short term.
Methods
A retrospective audit of patients who had successful (i.e. no implant loss at 3 months) fixed volume implant based reconstruction between June 2012 and June 2013 was carried out. Unplanned procedures to improve cosmesis were recorded. Nipple reconstruction and contralateral procedures were excluded.
Results
88 implants (69 patients) were included with an average of 38.6 months follow up. 39 implants (44%) required a mean of 1.36 (range 1-5) revisional surgeries. Lipomodelling accounted for 34%, implant exchange 30%, implant removal 21% and other procedures 15%. There was a significantly higher rate of revisional surgery in patients who had an early complication following the initial procedure (14/21 vs 25/67; p=0.018).
Conclusion
The potential requirement for revisional surgery to obtain satisfactory cosmesis in the first 3 years following immediate implant based reconstruction should be communicated to patients in a collaborative decision making process.
Increasingly reconstruction following mastectomy is carried out as an immediate procedure. Reconstruction options are varied and a collaborative approach between clinicians and patients is required. Patients are generally advised that implant based reconstructions may require maintenance surgery in the future. This study aimed to quantify how many patients required unplanned surgery to improve cosmesis, following successful immediate implant based reconstruction in the short term.
Methods
A retrospective audit of patients who had successful (i.e. no implant loss at 3 months) fixed volume implant based reconstruction between June 2012 and June 2013 was carried out. Unplanned procedures to improve cosmesis were recorded. Nipple reconstruction and contralateral procedures were excluded.
Results
88 implants (69 patients) were included with an average of 38.6 months follow up. 39 implants (44%) required a mean of 1.36 (range 1-5) revisional surgeries. Lipomodelling accounted for 34%, implant exchange 30%, implant removal 21% and other procedures 15%. There was a significantly higher rate of revisional surgery in patients who had an early complication following the initial procedure (14/21 vs 25/67; p=0.018).
Conclusion
The potential requirement for revisional surgery to obtain satisfactory cosmesis in the first 3 years following immediate implant based reconstruction should be communicated to patients in a collaborative decision making process.
Introduction
Increasingly reconstruction following mastectomy is carried out as an immediate procedure. Reconstruction options are varied and a collaborative approach between clinicians and patients is required. Patients are generally advised that implant based reconstructions may require maintenance surgery in the future. This study aimed to quantify how many patients required unplanned surgery to improve cosmesis, following successful immediate implant based reconstruction in the short term.
Methods
A retrospective audit of patients who had successful (i.e. no implant loss at 3 months) fixed volume implant based reconstruction between June 2012 and June 2013 was carried out. Unplanned procedures to improve cosmesis were recorded. Nipple reconstruction and contralateral procedures were excluded.
Results
88 implants (69 patients) were included with an average of 38.6 months follow up. 39 implants (44%) required a mean of 1.36 (range 1-5) revisional surgeries. Lipomodelling accounted for 34%, implant exchange 30%, implant removal 21% and other procedures 15%. There was a significantly higher rate of revisional surgery in patients who had an early complication following the initial procedure (14/21 vs 25/67; p=0.018).
Conclusion
The potential requirement for revisional surgery to obtain satisfactory cosmesis in the first 3 years following immediate implant based reconstruction should be communicated to patients in a collaborative decision making process.
Increasingly reconstruction following mastectomy is carried out as an immediate procedure. Reconstruction options are varied and a collaborative approach between clinicians and patients is required. Patients are generally advised that implant based reconstructions may require maintenance surgery in the future. This study aimed to quantify how many patients required unplanned surgery to improve cosmesis, following successful immediate implant based reconstruction in the short term.
Methods
A retrospective audit of patients who had successful (i.e. no implant loss at 3 months) fixed volume implant based reconstruction between June 2012 and June 2013 was carried out. Unplanned procedures to improve cosmesis were recorded. Nipple reconstruction and contralateral procedures were excluded.
Results
88 implants (69 patients) were included with an average of 38.6 months follow up. 39 implants (44%) required a mean of 1.36 (range 1-5) revisional surgeries. Lipomodelling accounted for 34%, implant exchange 30%, implant removal 21% and other procedures 15%. There was a significantly higher rate of revisional surgery in patients who had an early complication following the initial procedure (14/21 vs 25/67; p=0.018).
Conclusion
The potential requirement for revisional surgery to obtain satisfactory cosmesis in the first 3 years following immediate implant based reconstruction should be communicated to patients in a collaborative decision making process.
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