Abstract

Several clinical studies have reported autologous breast reconstruction (ABR) to be associated with a higher postoperative complication rate; however, few have investigated the impact of reconstructive modality on complication severity. This study examines the impact of reconstructive modality on complication severity in a matched cohort of patients who underwent ABR versus implant-based breast reconstruction (IBR).A retrospective study of patients who underwent nipple-sparing mastectomy with immediate reconstruction was performed. Propensity score matching (PSM) ensured adequate matching of patients who underwent ABR and staged prepectoral IBR, respectively. Patient demographics, breast measurements and postoperative outcomes, including the incidence and severity of complications were analyzed. Multivariable logistic regression analysis was performed. A P-value of <0.05 was considered significant.128 patients (214 breast reconstructions) were included for analysis (ABR n = 64; IBR n = 64). No difference in overall complication rate was noted (p = 0.61). However, a significant association of IBR with major complications was noted (p = 0.02). In contrast, minor complications were significantly more frequent following ABR (p = 0.04).While the reconstructive modality did not appear to have an effect on the overall complication rate, it did significantly affect the severity of postoperative complications with major and minor complications being associated with IBR and ABR, respectively. These findings are relevant to patient-centered decision-making as they provide further granularity regarding postoperative complications and address the issue of complication severity.

View details for DOI 10.1097/PRS.0000000000009827

View details for PubMedID 36332003