A single surgeon's 12-year experience with tissue expander/implant breast reconstruction: Part II - An analysis of long-term complications, aesthetic outcomes, and patient satisfaction Journal Article
| Authors: | Cordeiro, P. G.; McCarthy, C. M. |
| Article Title: | A single surgeon's 12-year experience with tissue expander/implant breast reconstruction: Part II - An analysis of long-term complications, aesthetic outcomes, and patient satisfaction |
| Abstract: | BACKGROUND: Few reports have critically evaluated long-term outcomes following two-stage implant reconstruction. The objective of this study was to evaluate long-term aesthetic results, late complications, and patient satisfaction following tissue expander/implant breast reconstruction. A single surgeon's extensive experience with implant-based reconstruction provides an opportunity to evaluate these results in a uniformly treated patient population. METHODS: A total of 1522 tissue expander/implant reconstructions were initiated in 1221 patients from July of 1992 to June of 2004. Data on a cohort of 315 patients (410 reconstructions) with a minimum of 1 year of follow-up were entered into a prospectively maintained outcomes database. Overall aesthetic grade, capsular contracture grade, patient satisfaction, and late complications were prospectively evaluated, and outcome data were recorded on an ongoing basis. RESULTS: Mean follow-up was 36.7 months. Eighty-eight percent of patients had a good to excellent aesthetic result. Laterality of reconstruction (bilateral versus unilateral) and radiation history were significant predictors of overall cosmesis. Aesthetic results were not related to preoperative breast size, implant volume, or body mass index. Pathologic capsular contractures (grade III/IV) developed in 10.4 percent of patients. Four percent of all permanent implants were exchanged for a second prosthesis. Ninety-five percent of patients were satisfied with their reconstruction. CONCLUSIONS: Tissue expander/implant reconstruction yields good to excellent long-term aesthetic results in the majority of patients, and overall patient satisfaction remains high. Bilateral reconstructions have higher overall aesthetic grades. Reconstruction may be performed in patients with larger-volume breasts with satisfactory cosmesis. Successful outcomes are possible in patients who receive chest wall irradiation. Copyright ©2006 by the American Society of Plastic Surgeons. |
| Keywords: | adult; controlled study; treatment outcome; aged; middle aged; patient satisfaction; major clinical study; combined modality therapy; outcome assessment; follow up; prospective studies; mastectomy; breast reconstruction; prediction; radiation exposure; postoperative complication; postoperative complications; body mass; preoperative period; breast endoprosthesis; esthetics; breast implants; breast implantation; contracture; tissue expanders |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 118 |
| Issue: | 4 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2006-09-15 |
| Start Page: | 832 |
| End Page: | 839 |
| Language: | English |
| DOI: | 10.1097/01.prs.0000232397.14818.0e |
| PUBMED: | 16980843 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 53" - "Export Date: 4 June 2012" - "CODEN: PRSUA" - "Source: Scopus" |
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