Long-term implant survival in delayed breast reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Delayed implant-based breast reconstruction is a common procedure.
• Understanding long-term implant outcomes is crucial for patient counseling and surgical planning.

Purpose of the Study:

• To determine the incidence of implant-related operations and revisions after delayed implant-based breast reconstruction.
• To analyze implant survival rates over a 20-year period.

Main Methods:

• Ancillary study to the Gothenburg Breast Reconstruction Study (GoBreast).
• Kaplan-Meier method for implant loss estimation.
• Log-rank tests and Cox proportional hazards model for comparisons and multivariable analysis.

Main Results:

• Included 881 implants and 603 patients with a mean follow-up of 8.2 years.
• 20-year implant survival rate was 57% (95% CI 54-61%).
• Implant survival was significantly lower for direct-to-implant procedures (P < 0.001).

Conclusions:

• Approximately half of implants in delayed breast reconstructions survive two decades without additional surgery.
• Serial implant revisions are more common than single revisions.
• First implant revisions may predict subsequent revision needs for the second implant.