Table 2. Subsequent Breast Reconstruction and Revision Procedures Within 2 Years of Immediate Reconstruction According to 90-Day Complications After Immediate Implant or Autologous Reconstructiona.
| Type of IR, Complication | No. of Complications ≤90 d After Mastectomyb | No. of Subsequent Reconstruction or Revision Procedures, Mean (Range)c | P Valued | |
|---|---|---|---|---|
| Implant (n = 7655) | ||||
| None | 6475 | 1.37 (0-8) | Reference | |
| SSI | 685 | 2.08 (0-9) | <.001 | |
| NIWC | 717 | 1.88 (0-9) | <.001 | |
| SSI or NIWC | 1180 | 1.92 (0-9) | <.001 | |
| Autologous flap only (n = 1799) | ||||
| None | 1457 | 0.87 (0-6) | Reference | |
| SSI | 177 | 1.14 (0-6) | .002 | |
| NIWC | 250 | 1.12 (0-6) | .002 | |
| SSI or NIWC | 342 | 1.11 (0-6) | <.001 | |
| Autologous flap plus implant (n = 593) | ||||
| None | 495 | 1.30 (0-7) | Reference | |
| SSI | 52 | 1.58 (0-5) | .34 | |
| NIWC | 63 | 1.41 (0-4) | .64 | |
| SSI or NIWC | 98 | 1.51 (0-5) | .22 | |
Abbreviations: IR, immediate reconstruction; NIWC, noninfectious wound complication; SSI, surgical site infection.
Subsequent reconstruction or revision procedures included the first secondary implant or autologous procedure; implant removal without insertion, revision of reconstruction, mastopexy, capsulectomy, nipple reconstruction, reduction mammoplasty, and any additional subsequent autologous or implant procedures (ie, autologous and implant insertion codes in addition to the following: Current Procedural Terminology, 4th edition codes 11970, 11971, 19316, 19318, 19328, 19350, 19370, 19371, and 19380; International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes 85.31, 85.32, 85.6, 85.87, 85.89, 85.93, 85.94, and 85.96). Of all procedures within 2 years after mastectomy and before any subsequent mastectomy, 5851 (43.0%) were the first secondary implant or autologous procedure. Overall, the most common follow-up procedure was implant exchange or insertion (8212 [60.4%] of all procedures within 2 years), followed by nipple reconstruction (with or without revision or mastopexy, 2565 [18.9%]), revision or mastopexy only (1063 [7.8%]), implant removal only (806 [5.9%]), and autologous flap reconstruction without an implant (230 [1.7%]).
SSI and NIWC categories are not mutually exclusive; thus, the sum of the number of women by complication category is greater than the number of women with IR.
Includes subsequent procedures up to 2 years after mastectomy and before any subsequent mastectomy. Among women with IR, 8172 (81%) had at least 1 year of enrollment and 5683 (57%) had at least 2 years of health insurance enrollment after mastectomy.
Calculated using the Kruskal-Wallis test comparing SSI vs no complication and NIWC vs no complication.