Zinner Gauthier, Martineau Jérôme, Lam Giang Thanh, Correia Daniel, Kalbermatten Daniel F, Oranges Carlo M
From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.
Department of Gynecology, Geneva University Hospitals, Geneva University, Geneva, Switzerland.
Plast Reconstr Surg Glob Open. 2025 Jan 10;13(1):e6425. doi: 10.1097/GOX.0000000000006425. eCollection 2025 Jan.
Prepectoral (PP) immediate implant-based breast reconstruction (IBBR) is gaining popularity over the retropectoral (RP) breast reconstruction technique. This study aims to compare complication rates across different body mass index (BMI) groups in patients undergoing PP or RP IBBR.
A monocentric retrospective analysis was conducted on patients who underwent mastectomy and IBBR from January 2018 to December 2023. Preoperative characteristics, BMI, type of mastectomy procedure, PP or RR implant placement, and postoperative outcomes were collected and analyzed.
A total of 217 patients were included, representing 276 IBBRs. The overall complication rate on a per breast basis was 26.4%. The overall complication rate did not differ across BMI groups ( = 0.314) and between PP and RP IBBR ( = 0.8083). In the PP group, anemia rate increased with low BMI (odds ratio [OR] 0.0215, = 0.033) and skin complications were more frequent with higher BMI (OR 0.0428, = 0.0389). In the RP group, higher BMI was correlated with a higher seroma rate in the RP IBBR group (OR 1.2045, = 0.0334) and a longer hospital length of stay (coefficient 0.248, adjusted ² 0.082, SD 0.098, = 0.014).
PP IBBR was associated with a significantly higher rate of anemia in patients with low BMI, and a significantly higher rate of skin complications in high BMI. RP IBBR was associated with higher seroma rate and longer hospital length of stay in patients with higher BMI.
胸前（PP）即刻植入式乳房重建（IBBR）相较于胸后（RP）乳房重建技术越来越受欢迎。本研究旨在比较接受PP或RP IBBR的不同体重指数（BMI）组患者的并发症发生率。
对2018年1月至2023年12月期间接受乳房切除术和IBBR的患者进行单中心回顾性分析。收集并分析术前特征、BMI、乳房切除手术类型、PP或RR植入物放置情况以及术后结果。
共纳入217例患者，共进行了276例IBBR。每侧乳房的总体并发症发生率为26.4%。总体并发症发生率在不同BMI组之间（P = 0.314）以及PP和RP IBBR之间（P = 0.8083）没有差异。在PP组中，贫血发生率随BMI降低而增加（优势比[OR] 0.0215，P = 0.033），皮肤并发症在BMI较高时更常见（OR 0.0428，P = 0.0389）。在RP组中，较高的BMI与RP IBBR组中较高的血清肿发生率相关（OR 1.2045，P = 0.0334）以及更长的住院时间（系数0.248，校正R² 0.082，标准差0.098，P = 0.014）。
PP IBBR与低BMI患者中显著更高的贫血发生率以及高BMI患者中显著更高的皮肤并发症发生率相关。RP IBBR与高BMI患者中更高的血清肿发生率和更长的住院时间相关。
