Breast Envelope Complications After Revision Breast Implant Surgery: A Systematic Review

Area of Science:

• Plastic Surgery
• Aesthetic Medicine
• Surgical Complications

Background:

• Revisional cosmetic breast augmentation presents unique challenges, including compromised blood flow due to prior surgeries, tissue thinning, and ptosis.
• Limited research exists on breast vascularity following augmentation, impacting revision outcomes.
• This review focuses on envelope-related complications in revisional aesthetic breast augmentation.

Purpose of the Study:

• To review the current literature on envelope-related complications in patients undergoing revisional aesthetic breast augmentation.
• To identify common complications and influencing factors in secondary breast implant surgery.

Main Methods:

• A comprehensive literature review was conducted between October and December 2024, adhering to PRISMA guidelines.
• Databases searched included Cochrane, Google Scholar, and PubMed/Medline.
• Data extracted covered study design, patient demographics, vascularity assessment methods, complication types and rates, and revision details.

Main Results:

• Out of 895 initial publications, 12 studies involving 1515 patients were included.
• A total of 43 patients (2.84%) experienced envelope-related complications.
• Common complications included tissue issues, delayed wound healing, nipple problems, and necrosis.

Conclusions:

• Secondary implant surgery complications pose challenges for patients, surgeons, and insurers.
• Preoperative and intraoperative imaging may assist in planning successful revisions.
• Further studies are required to validate the efficacy of imaging in reducing complications.