Outcomes and Complications of Implant-Based Breast Reconstruction in Patients With Previous Cosmetic Augmentation: A Systematic Review.

Breast augmentation is a very popular cosmetic surgery-which may subsequently influence the technique and outcomes of breast reconstruction in the event of breast cancer. After mastectomy, several surgical approaches are available for this patient population. The authors of this study aim to systematically review the available methods, their associated complications, and patient satisfaction outcomes. A comprehensive search of the PubMed/MEDLINE database was conducted by structured search algorithms to identify relevant studies. Three reconstruction techniques were categorized, and related complications and outcomes were compiled into tables for analysis. A total of 11 studies on implant-based breast reconstruction met the inclusion criteria. Three main surgical techniques were identified: tissue expander-to-implant (TE; = 250 breasts) reconstructions, implant-sparing mastectomies (ISMs; = 196 breasts), and direct-to-implant (DTI; = 137 breasts) reconstructions. The overall complication rates were 54.8% for TE, 22.4% for ISM, and 25.5% for DTI, and the most frequent complications were infection, necrosis, and capsular contraction, respectively. Patient satisfaction in TE and DTI groups ranged from average to high for the 3 domains explored, namely psychosocial well-being, breast satisfaction, and sexual well-being (ISM not reported). Three primary techniques to address implant-based breast reconstruction in patients with previous breast augmentation are described in literature: TE, ISM, and DTI. Patients necessitating TE present a high complication rate, whereas ISM and DTI show a safer profile. Patient satisfaction evaluated with BREAST-Q scores in TE and DTI groups appeared to vary from average to high.