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Minimally Invasive and Innovative Management of Prosthesis Infections in Endoscopic-Assisted Breast Reconstruction

  • Innovative Techniques
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Implant infection continues to be the most common complication of breast reconstruction, and it can lead to serious consequences of implant loss. Recently, endoscopic-assisted nipple-sparing mastectomy with direct-to-implant breast reconstruction is being performed more frequently, with similar prosthetic infection incidence compared to conventional techniques. But there is little information published in the literature on the management of periprosthetic infection in endoscopic-assisted breast reconstruction.

Methods

A retrospective review was performed of patients who underwent endoscope-assisted breast reconstruction and developed periprosthetic infection between January 2020 and December 2022. Prosthesis infection was defined as any case where antibiotics were given, beyond the surgeon’s standard perioperative period, in response to clinical signs such as swelling, pain, erythema, increased temperature, fever, etc. We summarized our clinical approach and treatment protocol for periprosthetic infection patients. Collected data include preoperative basic information, surgical details, postoperative data, and outcomes.

Results

A total of 580 patients (713 reconstructions) underwent endoscopic-assisted immediate breast reconstruction. There were 58 patients developed periprosthetic infection, 14 of whom had bilateral prosthesis reconstruction with unilateral prosthesis infection. The incidence of infection was 10.0%. Average follow-up was 17.3 ± 8.9 months (range = 2–37 months). Of the 58 patients, 53 (91.4%) patients successful salvaged implant and 5(8.6%) patients removed prosthesis. During follow-up, Baker III capsular contracture occurred in 2 patients (3.8%) who had radiotherapy.

Conclusion

Our management of prosthesis infections in endoscopic-assisted breast reconstruction is easy, minimally invasive, and inexpensive. This method can be repeated if the implant infection does not improve after the first drainage. What’s more, our data suggest that our prosthesis salvage of periprosthetic infection is effective.

Level of Evidence IV

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Author notes

  1. Yanyan Xie and Xiaoxia Hu have contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China

    Yanyan Xie, Xiaoxia Hu, Zhenggui Du, Faqing Liang, Qing Lv & Bo Li

  2. Breast Center, West China Hospital, Sichuan University, Chengdu, China

    Yanyan Xie, Xiaoxia Hu, Zhenggui Du, Faqing Liang & Qing Lv

Authors
  1. Yanyan Xie
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  2. Xiaoxia Hu
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  3. Zhenggui Du
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  4. Faqing Liang
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  5. Qing Lv
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Contributions

(I) Conception and design: QL, BL, YX; (II) Administrative support: none; (III) Provision of study materials or patients: QL, YX, ZD; (IV) Collection and assembly of data: XH, ZD, FL; (V) Data analysis and interpretation: YX, XH; (VI) Manuscript writing: all authors; (VII) Final approval of manuscript: all authors.

Corresponding authors

Correspondence to Qing Lv or Bo Li.

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This article does not contain any studies with human participants or animals performed by any of the authors as it was a retrospective study.

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Xie, Y., Hu, X., Du, Z. et al. Minimally Invasive and Innovative Management of Prosthesis Infections in Endoscopic-Assisted Breast Reconstruction. Aesth Plast Surg 48, 266–272 (2024). https://doi.org/10.1007/s00266-023-03525-6

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  • DOI: https://doi.org/10.1007/s00266-023-03525-6

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