Article
Complications in free autologous breast reconstruction – how often is surgical intervention warranted and to what degree?
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Published: | September 10, 2013 |
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Outline
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Introduction: In the words of Robert M. Goldwyn: “Breast reconstruction begins as reconstructive procedure but ends as aesthetic procedure.” In order to achieve this goal we need to ensure that patient satisfaction rides high and the end result is not compromised.
Methods: Over the last six years, we have retrospectively looked at the complications encountered in our patients who had undergone free autologous breast reconstruction. We have noted the operative intervention undertaken to deal with the complication and analysed the end result of the reconstruction in relation to the complication experienced.
Results: 800 patients (908 flaps – 108 bilateral) were identified in the study period. Total flap loss occurred in 6 flaps (0.7%), partial flap loss of 30-50% of the flap occurred in 13 flaps (1.4%) and marginal necrosis of
Conclusion: Every revision has a conflicting priority between flap survival and the aesthetic outcome of the breast reconstruction. In early revision surgery where the flap may only survive partially on salvage, it might be best to denounce the partially failing flap and perform a new reconstructive procedure rather than compromising on patient satisfaction in the long run.