In Selected Cases, Immediate Reconstruction Provides Good Results with Low Complication Rate
Philadelphia, PA (April 11, 2011) – Immediate breast reconstruction using implants provides a new alternative for many women undergoing mastectomy for breast cancer, suggests a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Although it’s not appropriate for all women, immediate breast implant placement provides “very good aesthetic results” with a low complication rate, according to the report by Dr. Christopher A. Crisera and colleagues at University of California Los Angeles. Immediate implant placement may also help lessen psychological distress, while reducing the need for multiple surgical procedures and associated costs.
Good Results with Immediate Implant Placement after Mastectomy
Dr. Crisera and co-authors report on the results of immediate implant-based breast reconstruction in 35 women with breast cancer. In this procedure, breast reconstruction with silicone-gel implant placement was performed immediately after mastectomy. The women’s average age was 45 years; most underwent double mastectomy with immediate reconstruction of both breasts.
In the study, mammograms obtained some years after fat injection showed “clustered microcalcifications” in eight of the 48 women-a rate of 16.7 percent. In all eight cases, the microcalcifications were regarded as “highly suspicious” for breast cancer.
The immediate implant reconstruction technique was made possible by the use of modern surgical materials and approaches including “skin-sparing” mastectomy techniques that preserve the normal breast skin. The results were assessed an average of 15 months after surgery.
Six of the women had some type of complication-a rate of 16.6 percent. Only one of these complications was serious enough to cause loss of the implant. Overall, 37 percent of the women required additional surgery for revision.
The aesthetic results were rated good to excellent with an average score of 3.19 on a 1-to-4 rating scale. Complication and revision rates were higher for women who had undergone radiation therapy for breast cancer, who had large breasts (D-cup or larger), and who had ptotic (sagging) breasts. The same characteristics were also associated with lower aesthetic scores.
Immediate implant placement offers some potentially important advantages over other approaches to reconstruction after mastectomy. By avoiding the need for a separate reconstructive surgery, it reduces anesthesia and other surgical risks.
Immediate reconstruction may also lessen some of the psychological distress associated with mastectomy. In addition, it can reduce hospital days and costs. In the current study, the average hospital stay was less than two days.
Although more experience is needed, the results suggest that immediate implant placement provides a valuable new approach to breast reconstruction after mastectomy. Dr. Crisera and co-authors conclude: “We believe that the possible advantages of immediate single stage implant based reconstruction, such as the potential to complete reconstruction with fewer operations and in less time and cost warrant its use in the appropriately selected patient.”
Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery7reg; (http://journals.lww.com/plasreconsurg/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
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The American Society of Plastic Surgeons (http://www.plasticsurgery.org/) is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
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