Post-mastectomy Implant Complications

Almost one third of women who undergo breast implantation develop at least one adverse event within three months of the surgery, a new study has found. The most common problems are infection, blood clotting, seroma (build-up of fluid in the tissue), and skin perforation.

On the positive side, permanent loss of an implant appears to be rare, according to Dr. Trine Henriksen of the Danish Registry for Plastic Surgery of the Breast (Copenhagen, Denmark).The registry collects baseline and follow-up data on women having cosmetic or corrective breast augmentation or reconstructive breast implantation at public and private clinics in Denmark. The findings were reported in the December 2005 issue of the Archives of Surgery.

Twenty-one percent of the women needed additional surgery to treat complications or to optimize the cosmetic result, most frequently because of capsular contracture (when scar tissue tightens and hardens), asymmetry or displacement of the implant, and peri-prosthetic infection. The researchers noted, however, that 48% of the subsequent implantations were planned, as part of a two-stage implant process (in which the first stage was a tissue expander).

Many more women today can choose between a mastectomy, which involves removal of the entire breast, and lumpectomy, in which only a portion of the breast is removed, followed by radiation treatment. Subsequent breast reconstruction can be done with an implant, with tissue taken from another part of the woman's body, or a combination of the two. Implantation is the most frequent, the study authors said. It is also the simplest procedure and requires the least amount of time.

Dr. Henriksen and colleagues concluded that because women having reconstructive implants after mastectomy will have a relatively high level of adverse events, detailed information on the complications should be "an essential part” of informed consent.