Fat Necrosis in Autologous Abdomen-Based Breast Reconstruction

Khansa, Ibrahim; Momoh, Adeyiza O.; Patel, Pratik; Nguyen, John; Miller, Michael J.; Lee, Bernard T.

doi:10.1097/prs.0b013e31827c6dc2

Cited by 62 publications

(51 citation statements)

References 53 publications

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“…Along similar lines, the presence of a small area of fat necrosis may not require intervention or might be resolved with simple liposuction, but fat necrosis can also sometimes lead to atrophy and contracture of the reconstructed breast. 17, 18, 32-34 Although not all fat necrosis identified in this study may have been clinically consequential, we do believe that the increased rate of this complication in radiated patients merits consideration, particularly because it can necessitate additional imaging, cause anxiety, and even require surgical intervention.…”

Section: Discussionmentioning

confidence: 80%

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer

et al. 2016

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Objective To evaluate complications after post-mastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy. Summary-Background Data Most studies of complications after breast reconstruction have been conducted at centers of excellence; relatively little is known about complication rates in radiated patients treated in the broader community. This information is relevant for breast cancer patients' decision-making. Methods Using the claims-based MarketScan database, we described complications in 14,894 women undergoing mastectomy for breast cancer from 1998-2007 who received immediate autologous reconstruction (n=2637), immediate implant-based reconstruction (n=3007), or no reconstruction within the first two postoperative years (n=9250). We used a generalized estimating equation to evaluate associations between complications and radiotherapy over time. Results Wound complications were diagnosed within the first two postoperative years in 2.3% of patients without reconstruction, 4.4% with implants, and 9.5% with autologous reconstruction (p<0.001). Infection was diagnosed within the first two postoperative years in 12.7% of patients without reconstruction, 20.5% with implants, and 20.7% with autologous reconstruction (p<0.001). 5219 (35%) women received radiation. Radiation was not associated with infection in any surgical group within the first six months but was associated with an increased risk of infection in months 7-24 in all three groups (each p<0.001). In months 7-24, radiation was associated with higher odds of implant removal in patients with implant reconstruction (OR 1.48, p<0.001) and fat necrosis in those with autologous reconstruction (OR=1.55; P=0.01). Conclusions Complication risks after immediate breast reconstruction differ by approach. Radiation therapy appears to modestly increase certain risks, including infection and implant removal.

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Section: Discussionmentioning

confidence: 80%

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer

et al. 2016

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“…40 A recent systematic review of the literature with 5059 DIEP flaps found a fat necrosis rate of 8.7% among patients with no history of irradiation, which was significantly lower than in patients who underwent pre-reconstruction (11%, p Z 0.022) and post-reconstruction irradiation (22.3%, p < 0.001). 43 However, a notable observation in existing literature is the division of opinion regarding the deleterious effects of radiation therapy on the outcome of free-flap breast reconstruction, and hence the differing preference in the timing of surgery in relation to PMRT.…”

Section: Discussionmentioning

confidence: 98%

Does post-mastectomy radiotherapy affect the outcome and prevalence of complications in immediate DIEP breast reconstruction? A prospective cohort study

Taghizadeh¹,

Moustaki²,

Harris³

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Inclusion criteria were English-language publication, human subjects, ear reconstruction, extractable outcomes on complications, and full-text availability. Exclusion criteria were systematic reviews and meta-analyses, case reports and case series with fewer than 15 patients, and nonrelated with surgery (the method is also provided in other systemic review about fat necrosis in autologous breast reconstruction by Khansa et al 2 ). Finally, 260 articles were excluded and 60 articles were reviewed and analyzed (Fig.…”

Section: Methodsmentioning

confidence: 99%

Complication Rate of Autologous Cartilage Microtia Reconstruction

Long

Huang

2013

Plastic and Reconstructive Surgery Global Open

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Background:Autologous cartilage has been widely accepted as the frame material of ear reconstruction for patients with microtia. Although rare, there are multiple complications related with the surgical reconstruction techniques. The authors performed a systematic review of the English literature of microtia reconstruction to determine significant surgical factors that are predictors of postoperative complications.Methods:A PubMed search using the terms “ear reconstruction” and “microtia” was conducted. Articles were screened using predetermined inclusion and exclusion criteria. Data collected included patient characteristics, surgical techniques, the incidence of all kinds of complications, and the specific postoperative morbidity. Patient cohorts were pooled, and the incidence of complications was calculated. Significant predictors such as the use of tissue expander, simultaneously mid-ear reconstruction, with/without skin graft, and different fascia coverage were analyzed by chi-square test.Result:Of 320 articles found, 60 met the inclusion criteria. Totally 9415 patients with microtia were analyzed in this review with 1525 cases with complications. The overall complication incidence is 16.2% in average with a range of 0–72.9%. There was no significant difference when comparing the overall complication rate between with/without preexpansion 2-stage and multiple-stage techniques or with/without mid-ear reconstruction simultaneously.Conclusion:Although there is little agreement in literature regarding risk factors for complications, the authors were able to demonstrate several significant predictors by systematically analyzing 60 articles. Improved knowledge of the incidence of different complications related with various surgical methods can help surgeons provide improved preoperative counseling and take measures to minimize the risk.

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Fat Necrosis in Autologous Abdomen-Based Breast Reconstruction

Cited by 62 publications

References 53 publications

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer

Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer

Does post-mastectomy radiotherapy affect the outcome and prevalence of complications in immediate DIEP breast reconstruction? A prospective cohort study

Complication Rate of Autologous Cartilage Microtia Reconstruction

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