Risk factors for immediate prosthetic postmastectomy reconstruction

Area of Science:

• Plastic Surgery
• Oncology
• Breast Reconstruction

Background:

• Immediate postmastectomy prosthetic breast reconstruction (IPMPBR) is a common procedure.
• Understanding complications is crucial for patient outcomes.

Purpose of the Study:

• To retrospectively review complications associated with subpectoral prostheses in immediate postmastectomy breast reconstruction.
• To identify factors associated with periprosthetic infections (PPI) and prosthesis loss.

Main Methods:

• Retrospective chart review of 47 IPMPBR procedures in 44 women.
• Analysis of patient demographics, mastectomy indications, cancer stage, and adjuvant therapies.
• Evaluation of complications including prosthesis extrusion, periprosthetic infections, and prosthesis loss.

Main Results:

• One case of prosthesis extrusion and removal.
• Two cases of late periprosthetic infections (PPI) leading to prosthesis removal.
• Fill port migrations, prosthesis deflations, and multiple complications were significantly associated with PPI (P < 0.006).
• Skin flap cellulitis and postoperative seroma were also significantly associated with PPI (P < 0.003).
• These factors were significantly associated with involuntary prosthesis loss (n=3).

Conclusions:

• Fill port issues, prosthesis deflation, skin flap cellulitis, and seroma are significant risk factors for periprosthetic infections in IPMPBR.
• These complications also increase the likelihood of involuntary prosthesis loss.
• Adjuvant chemotherapy did not show a significant association with PPI in this cohort.