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[Postoperative course after immediate breast reconstruction: Comparison between five surgical techniques].

A Durry1, A Baratte1, C Mathelin2

  • 1Service de chirurgie plastique, hôpital civil Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.

Annales De Chirurgie Plastique Et Esthetique
|January 7, 2019
PubMed
Summary

Immediate breast reconstruction (IBR) using free flaps shows higher early complication rates and longer healing times compared to implants. However, free flaps do not have a higher failure rate in breast reconstruction.

Keywords:
Breast cancerCancer du seinComplicationsFree flapsImmediate breast reconstructionLambeaux libresProthesisProthèsesReconstruction mammaire immédiate

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Area of Science:

  • Plastic Surgery
  • Oncologic Surgery
  • Reconstructive Surgery

Background:

  • Immediate breast reconstruction (IBR) offers various surgical techniques.
  • Common methods include deep inferior epigastric perforator (DIEP) flap, gracilis, latissimus dorsi flap, expander implants, and definitive implants.

Purpose of the Study:

  • To compare the postoperative course of different immediate breast reconstruction techniques.
  • To analyze healing time, complications, surgical revisions, and failure rates across five IBR methods.

Main Methods:

  • Retrospective study of 193 patients undergoing IBR between 2012-2017 at CHU Strasbourg.
  • Data collected: healing time, complications, revisions, failure rates.
  • Comparison between five IBR techniques and two groups: free flaps vs. implants.

Main Results:

  • Implants group had significantly fewer early, minor complications than free flaps (8.6% vs. 33.3% unilateral; 10.9% vs. 38.9% bilateral).
  • Free flaps had no surgical failures, while implants had failure rates of 6.2% (definitive) and 3.6% (expander).
  • Healing time was longer for free flaps (5.6 weeks) compared to implants (4.2 weeks).

Conclusions:

  • Immediate breast reconstruction with free flaps is linked to increased early complications and prolonged healing.
  • Despite higher complication rates, free flaps do not exhibit a higher failure rate compared to implant-based reconstruction.