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J Reconstr Microsurg 2017; 33(04): 257-267
DOI: 10.1055/s-0036-1597822
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Breast Reconstruction in Elderly Patients: Risk Factors, Clinical Outcomes, and Aesthetic Results

Rosaria Laporta
1   Department of Plastic Surgery, “Sapienza” University of Rome, Sant'Andrea Hospital, Roma, Italy
,
Michail Sorotos
1   Department of Plastic Surgery, “Sapienza” University of Rome, Sant'Andrea Hospital, Roma, Italy
,
Benedetto Longo
1   Department of Plastic Surgery, “Sapienza” University of Rome, Sant'Andrea Hospital, Roma, Italy
,
Fabio Santanelli di Pompeo
1   Department of Plastic Surgery, “Sapienza” University of Rome, Sant'Andrea Hospital, Roma, Italy
› Author Affiliations
Further Information

Publication History

26 May 2016

16 November 2016

Publication Date:
06 January 2017 (online)

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Correction to:

Erratum to: Breast Reconstruction in Elderly Patients: Risk Factors, Clinical Outcomes, and Aesthetic ResultsJ Reconstr Microsurg 2017; 33(04): e1-e1
DOI: 10.1055/s-0037-1602379

Abstract

Background Correlation among age, clinical, and aesthetic outcomes in implant-based and autologous breast reconstructions was investigated.

Methods Between 2004 and 2014, a retrospective study was performed on patients who underwent reconstruction following mastectomy. Patients were divided in group A (< 50 years), group B (≥ 50–59 years), group C (≥ 60–69 years), and group D (≥ 70 years). Demographics, comorbidities, American Society of Anesthesiologists (ASA) class, and length of stay were assessed using chi-square and Kruskal–Wallis H analysis considering p ≤ 0.05 as significant. Pre- and postoperative photographs were taken to grade aesthetic results by patients and blinded plastic surgery team.

Results A total of 993 patients underwent 1,251 breast reconstructions, of which 356 (28.5%) were implant-based, 402 (32.1%) pedicled-flap, 445 (35.6%) free-flap, and 48 (3.8%) fat-graft reconstructions. There were 316 (25.2%) complications, of which 124 (34.8%) in implant-based, 74 (18.4%) in pedicled-flap, 111 (24.9%) in free-flap, and 2 (4.2%) in fat-graft reconstructions. Mean length of stay was 5.4 days without significant difference between age groups (p = 0.357). The incidence of overall complications was not significantly related to age, ASA class, smoking history, and previous radiotherapy. Body mass index was a significant predictor (p = 0.001), but odds ratio (OR: 1.2) demonstrated only a minimal increase in risk. Implant-based reconstruction was associated with a higher risk for complications compared with the other ones (OR: 2.5, p = 0.001). Patient and surgeon aesthetic surveys demonstrated an overall positive opinion in all age groups for each reconstructive option.

Conclusion Advanced age should not be considered a risk factor for breast reconstruction, while implant-based technique was associated with a higher risk for complications compared with autologous that may provide older women with greater benefits.

Keywords

Microvascular - free-tissue transfer - implant reconstruction - advanced age
 

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