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Incision Location Predicts 30-Day Major Adverse Events after Cosmetic Breast Augmentation: An Analysis of the
Denis S Valente1, Christopher J Pannucci1, Timothy W King1
1From the Mãe de Deus Health System Porto Alegre; Divisions of Plastic Surgery and Services Research, University of Utah; Departments of Surgery and Biomedical Engineering, and Division of Plastic Surgery, University of Alabama at Birmingham; University of Chicago; University of Illinois at Chicago; University of Pittsburgh School of Medicine; Cooper University Hospital; Graduate Program in Medicine and Health Sciences, School of Medicine, Pontifical University Catholic RS; Jawaharlal Institute of Postgraduate Medical Education & Research; Department of Surgery, Joan C. Edwards College of Medicine, Marshall University; University of Missouri-Kansas City School of Medicine; and University of Kansas School of Medicine.
The early major adverse event rate following cosmetic breast augmentation with implants is 0.37%. Key predictors include higher BMI, tobacco use, diabetes, and periareolar incisions.
Area of Science:
- Plastic Surgery
- Aesthetic Surgery
- Patient Safety
Background:
- Understanding early complications in breast augmentation is crucial for patient counseling and risk management.
- This study evaluates major adverse events in the early postoperative period after cosmetic breast augmentation.
Purpose of the Study:
- To assess the incidence of early major adverse events following cosmetic breast augmentation with implants.
- To identify independent predictors of these adverse events.
Main Methods:
- Retrospective cohort analysis of the Tracking Outcomes and Operations for Plastic Surgeons database.
- Inclusion criteria: women undergoing augmentation mammaplasty with implants between 2008 and 2016.
- Analysis of major adverse events including seroma, hematoma, wound disruption, and implant loss.
Main Results:
- A total of 84,296 patients were analyzed, with a 0.37% rate of major adverse events.
- Specific event rates: seroma (0.08%), hematoma (0.15%), deep wound disruption (0.09%), implant loss (0.11%).
- Independent predictors identified: BMI > 30 kg/m2 (RR 2.05), tobacco use (RR 2.25), and diabetes mellitus (RR 1.8). Periareolar incision increased risk (RR 1.77).
Conclusions:
- The overall early major adverse event rate for implant-based breast augmentation is low at 0.37%.
- Predictors such as elevated BMI, smoking, diabetes, and periareolar incisions are associated with increased risk.
- Periareolar incisions show a significantly higher risk for complications compared to inframammary incisions.
