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Risk factors of implant loss and complications post-implant based breast reconstruction: A meta-analysis

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Abstract

Breast cancer is considered to be the third most common cancer worldwide. Most patients undergo breast reconstruction as the primary intervention post-resection, either as implant-based, autologous reconstruction, or both. We aim to review the common risk factors and complications following implant-based reconstruction (IBR) surgeries. This systematic review was designed and conducted using PRISMA guidelines. The literature was systematically searched in November 2021 using the following databases: MEDLINE, Cochrane, and EMBASE. Among the terms used to aid the search were the following: breast reconstruction, IBR, breast-implant or implant, and post-operative complications. Reviewing the literature resulted in a total of 329 publications. After implementing our criteria, 23 articles were included in this study, with a total of 15,751 patients, of whom 8661 patients underwent IBR and 7090 underwent delayed surgeries. Our meta-analysis resulted in higher risks of wound dehiscence (RR = 1.59), skin necrosis (RR = 1.9), and reoperation (RR = 1.3) following IBR. Analysis of pooled data revealed a significantly higher risk of skin necrosis, wound dehiscence, implant deflation/rupture, and reoperation rate in immediate implant-based reconstruction in comparison to delayed implant-based reconstruction. Furthermore, the overall complication rate was not significantly different between the two groups. 

Level of evidence: Not gradable 

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Data is available upon reasonable request from the corresponding author.

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Authors and Affiliations

  1. Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia

    Nawaf Alhindi & Anas Alzahrani

  2. Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

    Basma Bamakhrama & Hattan Aljaaly

  3. Department of Plastic and Reconstructive Surgery, National Guard Hospital, Jeddah, Saudi Arabia

    Basma Bamakhrama

  4. Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia

    Hatan Mortada

  5. Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia

    Hatan Mortada

  6. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

    Nashwa M. Ali

  7. Department of Plastic Surgery, King Abdulaziz Medical City, Riaydh, Saudi Arabia

    Abdullah Alruwaili

  8. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Abdullah Alruwaili

  9. Department of Otolaryngology-Head & Neck Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    Noor Baamir

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  1. Nawaf Alhindi
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Correspondence to Hatan Mortada.

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Nawaf Alhindi, Basma Bamakhrama, Anas Alzahrani, Hatan Mortada, Nashwa M. Ali, Abdullah Alruwaili, Noor Baamir and Hattan Aljaaly declare no conflict of interest.

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Alhindi, N., Bamakhrama, B., Alzahrani, A. et al. Risk factors of implant loss and complications post-implant based breast reconstruction: A meta-analysis. Eur J Plast Surg 46, 865–874 (2023). https://doi.org/10.1007/s00238-023-02077-x

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