Results of a recent study suggest that in terms of outcomes and patient satisfaction, immediate, single-stage, implant-based breast reconstruction compares well with the more traditional two-stage procedure in which tissue-expander placement is followed by exchange to implant.
A team of Boston-based plastic surgeons has done a retrospective review of consecutive patients who underwent immediate unilateral or bilateral breast reconstruction over an eight-year period. The study sample comprised 346 patients who had reconstruction of 582 breasts — 166 procedures were single-stage, the rest two-stage. The authors used postoperative-complication rates, revision rates and BREAST-Q patient-satisfaction scores as outcome measures. They also computed descriptive, bivariate and multiple regression statistics.
The authors found that single-stage patients were 87 percent more likely to require an additional revisionary procedure. Complication rates between the single-stage and two-stage groups were similar for minor infections, major infections, hematoma formation, seroma formation and minor and major necrosis.
“There is no difference in complication rates between single- versus two-stage implant-based breast reconstructions,” study author Srinivas M. Susarla, M.D., of Children’s Hospital, tells Cosmetic Surgery Times. “While patients who have single-stage reconstructions report higher satisfaction with sexual well-being, they are also more likely to require additional operative revisions. Patients who have two-stage reconstructions report higher levels of satisfaction with medical and office staff."
The study was published in the January issue of Plastic and Reconstructive Surgery.