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Breast Reconstruction Complications Analyzed

Latissimus dorsi myocutaneous flap with or without an implant seen as good choice

MONDAY, Oct. 30 (HealthDay News) -- In women undergoing immediate breast reconstruction, latissimus dorsi myocutaneous flap with or without an implant may represent a compromise between complication risk and a good cosmetic result, researchers report in the October issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Vincent Pinsolle, M.D., of Hopital Pellegrin Tondu in Bordeaux, France, and colleagues conducted a study of 249 women who underwent 266 immediate breast reconstructions over a 12-year period, including 61 percent who underwent latissimus dorsi myocutaneous flap with implant, 15 percent who underwent autologous latissimus dorsi myocutaneous flap, and 24 percent who underwent subpectoral implant.

The researchers found an overall complication rate of 49 percent and 10 reconstruction failures. They determined that there was a non-significant difference in complication rates for immediate breast reconstruction with implant alone (39 percent) and latissimus dorsi with or without implant (51 percent). They identified smoking, obesity and radiotherapy as the risk factors for complications, and smoking as the only risk factor for reconstruction failure.

"These results have led us to delay or contraindicate reconstruction in the case of obesity or heavy smoking," the authors conclude. "In the case of probable postoperative radiotherapy, we prefer to delay the breast reconstruction."

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