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Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study

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Abstract

Background

Due to fluctuations in contemporary trends for breast reconstruction, we aimed to perform a comparative analysis to assess postoperative outcomes and complications of immediate implant-based breast reconstruction (IBBR) with tissue expander before and over the course of the COVID-19 pandemic.

Methods

Consecutive adult women undergoing total mastectomy and immediate two-stage IBBR with tissue expanders between September 2018 and May 2021 were included. Two groups were compared: reconstructions performed before COVID-19 (pre-pandemic) and reconstructions performed after the implementation of the COVID-19 policies at our institution. We compared postoperative complications and perioperative outcomes (e.g., length of stay, expander volume, time for definitive implant) between groups.

Results

One hundred fourteen patients representing 192 reconstructions with expanders were included. One-hundred twenty-eight (66.6%) were performed before the COVID-19 pandemic, while 64 (33.3%) were performed during the pandemic. A larger proportion of reconstructions performed during the pre-pandemic era had a prolonged length of stay (≥ 2 days) compared to reconstructions performed during the COVID-19 pandemic (43% versus 9.4%, p < .001). The median time from immediate IBBR to initiate outpatient expansions (22 days [IQR, 15–34]; p = 0.45) and to conclude outpatient expansion was (52 days [IQR, 40–76]; p = 0.85) comparable between groups. The rates of 30-day complications and rates of complications during the expansion period were similar between groups.

Conclusion

Due to adjustments in perioperative management and the implementation of institutional and state recommendations, IBBR with tissue expander during the COVID-19 pandemic exhibited a reduced length of stay compared to pre-pandemic reconstructions without increased morbidity.

Level of evidence: Level IV, Risk/Prognostic

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Data Availability

Raw data were generated at the URMC. Derived data supporting the findings of this study are available from the corresponding author O.J.M. on request.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA

    Joseph M. Escandón, Alejandra Aristizábal, Howard N. Langstein, Jose G. Christiano & Oscar J. Manrique

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  1. Joseph M. Escandón
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  2. Alejandra Aristizábal
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  3. Howard N. Langstein
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  4. Jose G. Christiano
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  5. Oscar J. Manrique
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Corresponding author

Correspondence to Oscar J. Manrique.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethics committee approved this study (IRB#: STUDY00006499).

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The authors have no conflict of interests or commercial associations to disclose related to this study.

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Escandón, J.M., Aristizábal, A., Langstein, H.N. et al. Immediate two-stage implant-based breast reconstruction during the COVID-19 pandemic: retrospective single center study. Eur J Plast Surg 46, 1081–1092 (2023). https://doi.org/10.1007/s00238-023-02115-8

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  • DOI: https://doi.org/10.1007/s00238-023-02115-8

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