Implant Augmentation After DIEP Breast Reconstruction: A 14-Year Review of Hybrid Breast Reconstruction Outcomes

Implant placement after autologous breast reconstruction can provide excellent aesthetic outcomes for patients who desire larger breasts. The aim of this study was to review outcomes of patients who underwent breast implant placement after DIEP reconstruction and compare them to patients who did not undergo hybrid reconstruction.

A retrospective cohort study was performed comparing patients who underwent hybrid breast reconstruction (implant placement after DIEP) to DIEP patients alone. The 2 groups were compared using the Mann-Whitney U test for continuous variables and the Pearson χ2 test for categorical variables.

A total of 481 DIEP flaps performed by a single surgeon were included in the analysis, of which 20 flaps (13 patients) underwent hybrid reconstruction. Patients who underwent hybrid reconstruction were more likely to be younger (47 years old vs. nonhybrid, 52 years old, P = 0.031) and have a lower BMI (29 vs. nonhybrid, BMI 32, P = 0.037). The timing of reconstruction, laterality, smoking status, or history of massive weight loss or radiation were not significantly associated with hybrid reconstruction. The mean implant size was 256 cm3 (min: 150 cm3, max: 340 cm3). There were no significant complications after implant placement. Five out of 13 patients (38%) later underwent implant exchange.

Hybrid breast reconstruction with breast implant placement may be a safe and efficacious adjunct procedure after autologous reconstruction. Patients undergoing hybrid reconstruction tended to have lower BMI and desired larger breasts.