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Secondary Surgeries After Oncoplastic Reduction Mammoplasty
Ciara A Brown1, Oblaise A Mercury2, Alexandra M Hart3
1From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Emory University.
Annals of Plastic Surgery
|June 28, 2021
Summary
Secondary surgeries after oncoplastic breast reduction are common, with 21% of patients needing reoperation. Aesthetic improvement is the most frequent reason, particularly in younger patients, highlighting the need for careful technique and patient selection.
Area of Science:
- Oncoplastic surgery
- Breast reconstruction
- Surgical oncology
Background:
- Oncoplastic reduction mammoplasty is a common breast cancer treatment for patients with macromastia.
- Data on the frequency and reasons for secondary surgeries following this approach are limited.
Purpose of the Study:
- To evaluate the incidence and indications for all secondary surgeries after oncoplastic breast reduction.
Main Methods:
- A prospectively maintained database of 547 patients who underwent oncoplastic breast reduction between 1998 and 2020 was analyzed.
- Secondary surgeries were defined as unplanned returns to the operating room; demographic and clinical variables were assessed.
Main Results:
- 21% of patients (n=117) required 235 secondary surgeries, averaging 1.4 operations per patient.
- Indications included involved margins (7.5%), major complications (8.6%), aesthetic improvement (13.3%), and completion mastectomy (5.3%).
- Younger age (<65) correlated with any subsequent procedure and aesthetic revision; BMI > 35 increased operative complications.
Conclusions:
- Secondary surgeries are frequent after oncoplastic breast reduction, with early reasons including margin management and complications, and late reasons involving aesthetics and healing.
- Aesthetic improvement is the primary driver for reoperation, especially in younger patients.
- Optimizing surgical technique and patient selection can minimize non-oncological secondary surgeries.
