Is Getting a Second-Attempt Implant-Based Breast Reconstruction Worth the Risk?

Second-attempt breast reconstructions have higher rates of infection and decreased satisfaction.
Second-attempt breast reconstructions have higher rates of infection and decreased satisfaction.

While implant-based breast reconstruction can be a blessing if all goes well, that blessing quickly turns into a curse if it becomes infected. A recent study by Malke Asaad, MD, et al., published in the journal Plastic and Reconstructive Surgery, investigated the outcomes of second implant-based breast reconstruction surgeries following the removal of an infected implant.

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The retrospective study focused on patients the received second implants between January 2009 and December 2019. Out of the 6,093 patients that received implant-based breast reconstructions, 298 (5%) required device removal after infection. Eighty-three of these patients went on to get second-attempt breast implants, 36% of which developed one or more postoperative complications. Infection was the most commonly reported, with a total of 23 (25%) of the second-attempt reconstructions resulting in infection.

The study found that second-attempt reconstructions had a significantly higher rate of infection, with a total of 21%, compared to first-attempt cases, which only reported an infection rate of 9%. Patient satisfaction with the second-attempt reconstruction and sexual well-being was also reported as being lower than with the first attempt (p = 0.018 and p = 0.002, respectively).

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The authors concluded that while it is reasonable to offer woman the option of having a second-attempt implant-based breast reconstruction, these patients have a higher rate of infection and lower rate of satisfaction. It is therefore important to educate patients of the risks and give them realistic expectations before moving forward with the second-attempt reconstruction.

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