Breast Reconstruction after Mastectomy

A number of studies have found that obesity significantly increases the risk of both flap and donor complications. A meta-analysis also demonstrated that muscle-sparing abdominal flaps resulted in a lower pooled incidence of flap loss and fat necrosis.

While radiation is associated with higher wound healing complications with reconstruction, the rate of complications is similar whether reconstruction precedes or follows radiation.

Complication rates of immediate autologous reconstruction are similar between those taking neoadjuvant chemotherapy and those who do not.

There are no significant differences in the rate of chest wall recurrence after mastectomy whether a skin-sparing procedure with immediate reconstruction is performed or not.

Kelley BP, Ahmed R, Kidewll KM, Kozlow JH, Chung KC, Momoh AO. A systematic review of morbidity associated with autologous breast reconstruction before and after exposure to radiotherapy: are current practices ideal? Ann Surg Oncol. 2014;21:1732-1738.

Lee KT and Mun GH. Effects of obesity on postoperative complications after breast reconstruction using free muscle-sparing transverse rectus abdominis myocutaneous, deep inferior epigastric perforator, and superficial inferior epigastric artery flap: A systematic review and meta-analysis. Ann Plast Surg. Epub ahead of print December 19, 2014; doi: 10.1097/SAP.0000000000000400.

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