Correcting Implant Breast Reconstruction Complications with Autologous Flaps

By: Courtney Floyd

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Patients with breast cancer have many options when it comes to breast reconstruction. Many patients are also candidates for nipple-sparing mastectomy (NSM). The most common reconstructive procedure offered to NSM patients is tissue expander/implant reconstruction.

Implants can be a great option for many women, but can also be associated with a higher risk of complications (especially when radiation is in the mix). Frequently, implant related complications will require further surgery and the removal of the implant. When this occurs for NSM patients, there is also the potential of losing the nipple due to the additional surgery. Luckily, there are options to correct implant reconstruction complications that provide good cosmetic results without sacrificing the nipple!

A study published in the Aesthetic Surgery Journal followed 213 patients who underwent either direct-to-implant or tissue expander to permanent implant breast reconstruction after nipple-sparing mastectomies. The overall complication rate was 15.2%. Of the 58 patients who experience complications, 33 required additional surgery to remove the implants. The majority of the patients who required implant removal went on to have further reconstruction. About 30% of the patients chose to proceed with implant reconstruction again and 70% underwent autologous flap reconstruction. Regardless of the procedure performed, there was only a 2.1% chance of nipple loss due to the additional surgery.

This study proves additional breast reconstruction surgery following the removal of implants is safe and does not significantly increase the risk of nipple loss for NSM patients.

At PRMA, we see many patients who have ongoing issues related to implant reconstruction. Complications include capsular contracture, significant breast asymmetry, chronic pain and infection. Like majority of the patients in the above study, we typically recommend removal of the implant and surrounding scar tissue, and further reconstruction using the patient’s own tissue if possible. Procedures like the DIEP flap allow us to recreate a “natural”, soft, warm breast without the use of implants. Sensory nerve reconstruction can also be performed during DIEP flap surgery to help restore breast feeling.  

The surgeons of PRMA specialize in correcting failed implant reconstruction. If you are unhappy with your implant reconstruction, or have had ongoing problems with your implants and would like to learn more about your options, please fill out our free virtual consultation form today!

Salvage of Implant-Based Breast Reconstruction in Nipple-Sparing Mastectomies With Autologous Flaps.png

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