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Reoperative hybrid breast augmentation: An analysis of risk factors for complications and reoperations
Alexandre Mendonça Munhoz1, Ary de Azevedo Marques Neto2
1Plastic Surgery Division, Hospital Sírio-Libanês, São Paulo, Brazil; Breast Surgery Group, Plastic Surgery Division, University of São Paulo School of Medicine, Brazil; Plastic Surgery Department, Hospital Moriah, Member of the Brazilian Society of Plastic Surgery (SBCP), Brazil; International Member of the American Society of Plastic Surgeons (ASPS), USA.
Background:
Autogenous fat grafting (AFG) has become a common procedure to optimize aesthetic results in breast augmentation (BA). However, complications or outcomes in reoperative BA remain unclear. This study compared the outcomes or risk factors in reoperative BA with AFG and without AFG.
Objectives:
To assess outcomes from AFG in a large series of patients undergoing reoperative BA.
Methods:
We identified a retrospective cohort of patients who underwent secondary BA, and then established 2 groups that did and did not receive AFG. Charts were reviewed for complications or reoperations. The primary outcome was complications (identified clinically or via imaging), and regression logistic analysis was used to evaluate risk factors including age, body mass index, smoking, implant surface/volume, and previous pocket.
Results:
Overall, 293 patients were included (age: 41 ±9.4 years, follow-up: 70.4±30.7 months). In the AFG group (n = 111), 27.9% had at least 1 complication, most frequently capsular contracture; 12% had a previous submuscular pocket (43% presented animation deformities). In the non-AFG group (n = 182), 29.6% had at least 1 complication. No significant difference was observed between groups for total complications (p = 0.750) or reoperation (p = 0.665). AFG itself was independently associated with increased risk of altered imaging results (p = 0.002; OR = 2.92), predominantly oil cysts. In the AFG group, animation was completely resolved.
Conclusions:
Despite extensive AFG research, previous reoperative BA studies are limited and have not analyzed complications or long-term outcomes. AFG provides adequate tissue thickness to allow for a more superficial pocket, thus resolving animation issues. Our results indicate that AFG is a reliable technique that permits satisfactory outcomes and does not increase overall complication or reoperation rates compared to the procedures without AFG.
