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Risk Factors for Complications in Immediate Expander–Implant Breast Reconstruction for Non-obese Patients: Impact of Breast Size on Complications

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Abstract

Background

Although obesity is a well-known risk factor for complications in immediate expander–implant breast reconstruction, no studies have identified risk factors for non-obese patients. The purpose of this study was to identify risk factors for complications in non-obese patients.

Methods

A retrospective analysis of prospectively collected data from 397 consecutive immediate expander–implant breast reconstructions in 367 non-obese patients at a single institution over a 5-year period was conducted. Univariable and multivariable analysis were performed to determine the influence of six patient-related and eight procedure-related characteristics on complications.

Results

Mean BMI was 21.7 ± 2 kg/m2 and median mastectomy weight was 298.0 g (range: 40–1164 g). Multivariable analysis showed that neither BMI nor the use of acellular dermal matrix was a predictor for complications. Adjuvant radiation (odds = 3.12, p < 0.001) and mastectomy weight (p < 0.001) were independent risk factors for complications. A 100 g increase in the mastectomy weight was significantly associated with a 23 % increase in the odds of overall complications (p = 0.003), major complications (p = 0.004), and skin flap complications (p = 0.007), as well as a 28 % increase in the odds of seroma (p = 0.044), but was not associated with reconstruction failure. Adjuvant radiation (p < 0.001) and hypertension (p < 0.001) were risk factors for reconstruction failure.

Conclusions

Breast size was an independent risk factor for complications in non-obese patients while BMI was not. In the reconstruction of large breasts, greater attention and additional adjunctive procedures would be needed to prevent complications.

Level of Evidence III

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Acknowledgments

This study has no funding source. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

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Correspondence to Sa Ik Bang.

Additional information

Jai-Kyong Pyon and Kyong-Je Woo contributed equally as first authors.

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Woo, KJ., Paik, J.M., Mun, GH. et al. Risk Factors for Complications in Immediate Expander–Implant Breast Reconstruction for Non-obese Patients: Impact of Breast Size on Complications. Aesth Plast Surg 40, 71–78 (2016). https://doi.org/10.1007/s00266-015-0568-7

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  • DOI: https://doi.org/10.1007/s00266-015-0568-7

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