New study sheds light on early implant loss
Following a mastectomy, many women choose to rebuild their breasts through reconstruction surgery. The procedure can be done either during the same operation as the breast removal, or it can be postponed once the cancer treatment has finished and the chest has healed. According to the National Cancer Institute, the former is the most popular option for both breast cancer patients and women who want to prevent the illness. However, a new study might change the way women and their doctors look at post-mastectomy options.
A report published in the Journal of the American College of Surgeons stated that certain lifestyle factors such as obesity and smoking can lead to early breast implant loss, or the unplanned removal of an implant. After analyzing the medical records of more than 14,000 women from the database of the American College of Surgeons National Surgical Quality Improvement Program, the researchers found that obese patients have a two to three times higher risk of early breast implant loss, while the risk for smokers is three times greater than that of non-smokers.
The study also presented new data that shows that the failure rate for implants spikes for those who have progressive obesity, are over the age of 55 and underwent a one-stage mastectomy and reconstruction procedure.
Need for better assessment
According to lead author John P. Fischer, MD, these new findings could affect the way breast reconstruction is performed on high-risk breast cancer patients in the future.
"If a patient learns she has a high risk for complications with breast implants, she may choose to have an autologous tissue based procedure. The risk might not be worth it, or, on the other hand, the patient accepts the risk," Fischer said in the report. "Either way, the expectations are better managed and overall satisfaction is likely to be higher. Our main desire is to help improve the outcomes and care for breast reconstruction patients."
Fischer's findings are in line with a 2012 study from the journal Plastic and Reconstructive Surgery, which found that 45 percent of breast reconstruction surgeries on obese women used implants, especially if the reconstruction was immediately after the mastectomy. Implants had a 16 percent failure rate for obese women, compared to the 1.5 percent failure rate for autologous, or free flap, reconstruction.
The results of both studies show that to prevent early implant loss, plastic surgeons must properly asses their patients for potential risks and complications prior to the procedure. If risks arise, reconstruction might have to be delayed for the overall safety of the patient.