One Third of Women Have Complications After Breast Reconstruction

Rates of complications associated with breast reconstruction after a mastectomy are staggeringly high, according to a new study published in JAMA Surgery. This prospective cohort study conducted from 2012 to 2015 evaluated complications during 2-year follow-up of 2,343 patients who underwent breast reconstruction and found that 33% of them experienced general complications. Additionally, 19% required more surgery, 10% experienced infection, and 5% of the reconstructions failed.  

Rates of complications were significantly higher in reconstructions using the patients own tissue than in those using an artificial implant. Many of these autologous reconstructions utilized tissue from the patient’s midsection and resulted in abdominal weakness that made even simple activities feel strenuous.  

If I could go back in time I would NEVER have reconstruction on my left breast w/ tissue expander & implant. Even though I was DD. It caused me years of pain, and when they “lifted” my right breast to match the new side I lost all sensation in that one. https://t.co/u3toBOuvBy

— Abby Arnold (@abbysarnold) June 21, 2018

Despite these shortcomings, women with autologous reconstruction reported greater overall satisfaction and feelings of sexual well-being than those with artificial implants in another study. These confounding results indicate the complexity associated with the decision of which type of reconstruction to use.  

A possible drawback of this research is the relatively short amount of time the patients were observed. Dr. David H. Song notes that although the women receiving artificial implants may not have experienced immediate complications, they would likely require operation to have implants replaced several years down the road.  

Dr. Andrea L. Pusic, author of both studies, emphasized that the studies are not for deeming which operation is better than the other.

“They’re about filling in the blanks that aren’t always explained to women, so they know the pros and the cons and can make good decisions.” -Dr. Andrea L. Pusic, MD

Researchers go on to express that at 33%, the rate of complication after breast reconstruction is likely to be higher than the number commonly expressed to patients, however the operation restores the psychological benefit given from this feminine aspect of the patient’s body. For many women, this risk is a price they are willing to pay to regain their breasts.  

Sources: JAMA Surgery, JAMA Surgery, NY Times