Implant Exposure after Immediate Reconstruction for Breast Cancer

Background: The technique most frequently employed for breast reconstruction, either immediate (IBR) or delayed (DBR), is the insertion of a prosthesis. The placement of a foreign body always carries the risk, albeit small, of peri-prosthetic infection and exposure of the implant that necessitates its removal, signaling the temporary or permanent failure of the reconstruction. Methods: We retrospectively analyzed data of 738 consecutive patients immediate implant-only breast reconstructions between 1989 and 2005 in order to evaluate the contributing factors of failure. Results: Our statistical analysis identified 3 statistically significant risk factors of implant extrusion: irradiation (P = 0.01), post-operative chemotherapy (P = 0.03), and the use of non- Becker expanders (P= 0.02). Conclusions: It is important, especially for the multidisciplinary breast cancer team members, to be aware of these factors in order to make the optimal decision for immediate reconstruction after mastectomy and the suggested techniques. The patients should also be aware, as part of a shared medical decision, of the risks and their frequency before accepting IBR.