Implant-Based Reconstruction following Mastectomy in Patients Who Have Had a Previous Breast Augmentation: Lessons from the National Multicenter Implant Breast Reconstruction Evaluation Study

Ben Baker*, Emma Sewart, James Harvey, Shelley Potter

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
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Abstract

Background:
Breast augmentation is the most commonly performed cosmetic procedure, and increasingly women in this group present with breast cancer or request risk-reducing surgery, but their optimal management is unclear. The authors explored the clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation and compared these with outcomes of patients who had not had cosmetic implants in the Implant Breast Reconstruction Evaluation (iBRA) Study.

Methods:
Patients undergoing immediate implant-based breast reconstruction were prospectively recruited from breast and plastic surgical units across the United Kingdom. Demographic, operative, and oncologic data, and information regarding complications within 3 postoperative months were collected. Patient-reported outcomes at 18 months were assessed using the BREAST-Q. The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction with and without previous breast augmentation were compared.

Results:
A total of 2108 women were included in the iBRA Study, of whom 49 had undergone a previous augmentation. Women in the augmentation group were younger (median age, 45 years versus 50 years; p = 0.01), had a lower body mass index (22.8 kg/m2 versus 24.9 kg/m2; p < 0.01), and had smaller tumors (15 mm versus 25 mm; p = 0.01) than patients without augmentation. No differences were seen in operative technique between the groups. Complications at 3 months were similar in both groups and there were no significant differences in patient-reported outcomes at 18 months.

Conclusions:
The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation are consistent with those observed in the wider iBRA Study cohort, supporting the safety of this approach.
Original languageEnglish
Pages (from-to)324-337
Number of pages14
JournalPlastic and Reconstructive Surgery
Volume149
Issue number2
DOIs
Publication statusPublished - 1 Feb 2022

Bibliographical note

Funding Information:
This work was funded by a National Institute for Health Research, Research for Patient Benefit Programme grant (PB-PG-0214-33065); pump-priming funding from the Association of Breast Surgery and the British Association of Plastic Reconstructive and Aesthetic Surgeons; and a Research Development Award from the Association of Breast Surgery (2019). Shelley Potter, Ph.D., F.H.E.A., F.R.C.S., N.I.H.R., is a National Institute for Health Research Clinician Scientist (CS-2016-16-019). This work was undertaken with the support of the Medical Research Council ConDuCT-II (Collaboration and innovation for Difficult and Complex randomized controlled Trials In Invasive procedures) Hub for Trials Methodology Research (MR/K025643/1) and the National Institute for Health Research Biomedical Research Centre at University Hospitals Bristol National Health Service Foundation Trust and the University of Bristol.

Publisher Copyright:
Copyright © 2022 by the American Society of Plastic Surgeons.

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