Breast reconstruction: an analysis of the new trends and major complications

ABSTRACT

Introduction:

Because of its high incidence, breast cancer becomes a ma-jor concern, justified by psychological and social impacts. The purpose of the study is to analyze the current trends for breast reconstruction and evaluate its major complications. Method: A retrospective study was per-formed in a consecutive series of breast reconstructions in the period Feb-ruary 2011 to February 2012, through analysis of medical records.

Results:

A total of 127 breast reconstructions were performed. The immediate recon-structions represent 73% of the total. The following techniques were used: permanent silicone implant, 54% (n = 69), Becker adjustable implant, 14% (n = 17), transverse rectus abdominis myocutaneous flap (TRAM), 13% (n=17), latissimus dorsi flap and implant 13% (n=16) and single expander 6% of cases (n=8). Major complications occurred in 16.5% (n = 21) and most (63% n=12) had a history of radiation therapy, neoadjuvant chemo-therapy and / or smoking history. The complications resulted from hemato-ma reoperation (0.72% n=1), extensive necrosis of the flap requiring deb-ridement and / or positioning of the implant to recover the lost volume (4% n=5), infections (3 % n=4), extrusion and removal of the implant (7% n=9) and thromboembolic events (1.5% n=2).

Conclusion:

The choice of tech-nique for breast reconstruction must be individualized and based on the characteristics and desires of each patient, the familiarity of the tech-nique by the surgical team, the hospital resources available and costs generated by the techniques to optimize the results, reduce costs and complication rates.

Keywords:
Mastectomy; Mammaplasty; Reconstructive Surgical Proce-dures/Methods; Mammaplasty/Trends