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January 30, 2019 – Implants are generally the first choice for bad reconstruction after a mastectomy. But when implant-based reconstruction fails, autologous reconstruction – using the patient's own tissue – is a safe procedure that improves outcomes for the patient, reports a study in the February 2007 issue. Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
"Autologous bad reconstruction after failure of implant reconstruction is badociated with a significant improvement in patient satisfaction and quality of life," concludes the study of the SSPA surgeon, Joseph J. Disa, and colleagues at the Memorial Sloan Kettering Cancer Center, New York.
A study shows the safety and good results of repeated bad reconstruction
Implants are the most common option for bad reconstruction after mastectomy, used in approximately 80% of patients. But in some cases, the initial reconstruction fails because of complications or other reasons. In this situation, some patients opt for the autologous technique, the bad being reconstructed using its own tissue, usually using a flap obtained from a "site" donor "located in the abdomen.
Dr. Disa and her colleagues badyzed 137 women who underwent autologous bad reconstruction after the failure of implant reconstruction. In about three quarters of patients, initial reconstruction failed because of scarring around the implant (capsular contracture) causing pain or deformity. Other patients had infections or other complications related to the implants, or were not satisfied with the appearance of the reconstructed bad.
The second reconstruction was performed approximately 3.5 years on average after the initial procedure. Both bads were reconstructed in 55 patients for a total of 192 flaps. The results were evaluated using the BREAST questionnaire? Q © validated, which badesses various aspects of quality of life after bad reconstruction.
The results suggest that autologous reconstruction after failure of initial implant reconstruction is a safe procedure. Complication rates were similar to previous studies despite the additional challenges posed by capsular contracture or prior radiotherapy.
The badysis of BREAST-Q responses showed "a high degree of satisfaction and quality of life" after autologous reconstruction. About a quarter of patients completed the BREAST-Q after both implant procedures. This group had a significant improvement in satisfaction with the appearance of the bads, the psychosocial well-being and the physical well-being of the bad.
Women also reported improved satisfaction with overall well-being through the BREAST-Q system. This was despite a decrease in the physical well-being of the abdomen, linked to the donor site of tissue in the abdomen.
Implant and autologous reconstruction has advantages for bad reconstruction after mastectomy. While reconstruction using the patient's own tissue can give a more natural-looking bad, implant-based reconstruction is more widely available and less expensive. Both procedures are safe and give good reconstruction results.
This new study is one of the few to evaluate the results of autologous reconstruction after failure of an implant-based reconstruction and the first to use the validated BREAST-Q questionnaire. The findings show improvements in the physical and psychological well-being of this group of bad cancer survivors, as well as increased satisfaction with the appearance of the reconstructed bad (s).
"Whatever the reason for the failure of the implant, this study shows that switching to autologous tissue after removal of the implant is safe," conclude Dr. Disa and his co-workers. authors. Although there may be additional challenges related to previous bad cancer treatment and reconstruction, they add: "The procedure has an acceptable complication rate."
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Click here to read "Autologous Breast Reconstruction After Failure of Implant-Based Reconstruction"
DOI: 10.1097 / PRS.0000000000005197
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About SSPA
The American Society of Plastic Surgeons is the largest organization of plastic surgeons certified by the Board of Directors in the world. Representing more than 7,000 physician members, the company is recognized as a leading authority and source of information on aesthetic and reconstructive plastic surgery. ASPS brings together more than 94% of plastic surgeons certified by the US Board of Directors. Founded in 1931, the company represents physicians certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.
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