Surgical complications common to both surgical methods | |
---|---|
Major complications | Minor complications |
Implant or TE infection requiring removal of the prosthesis (3%, 80% reversible) | Implant or TE infection requiring only antibiotics (3% not severe, 100% reversible) |
Mastectomy skin flap problems resulting in removal of implant or TE (2%, 80% reversible) | Mastectomy skin flap problems requiring only conservative treatment and minor debridement in clinic (2% not severe, 100% reversible) |
Implant movement requiring additional surgery (3%, 80% reversible) | Visible implant rippling, shape deformity, or poor alignment not requiring correctional surgery (10 to 20%) |
Implant rippling, shape deformity, or poor alignment requiring surgery to correct it (10% not reversible) | |
 | Seroma or hematoma (1 to 2% not severe, 100% reversible) |
 | Long-term capsular contracture formation (25% develop grades III to IV in 10 years, not reversible) |
Possible complications present in the two-stage TE/I method | Possible complications present in the ADM one-stage method |
All need a second surgery for TE exchanged to implant under another general anesthetic | Hypothetical risk of pathogen or disease transmission from the processed human cadaveric donor tissue |
All need at least one postoperative TE inflation, on average three inflations that are performed either weekly or biweekly | One-stage method may not be possible for patients who wish to have larger breast sizes postoperative than they had preoperative |
All need to wait approximately 3 (±1) months following completion of the TE expansion process prior to the second surgery | Need for two drains rather than one drain per breast |
May be discomfort associated with TE inflation | Some reports of increased seroma formation with the use of ADM |
Saline leak from the TE may occur and can result in an additional surgery | May be more pain postoperatively with suturing of the ADM down to the chest wall along the inframammary fold |
TE may be malpositioned or migrate postoperatively requiring revision surgery prior to TE exchange | There may be more asymmetry between the two sides since there is only surgery to reconstruct the breast mound (versus two opportunities for symmetry correction in the two-stage) |
May be additional complications resulting from two surgeries | Less control with the patients selecting the volume of their reconstructed breasts compared to the two-stage TE/I group |
May be higher risk of hematoma formation from the need to elevate pectoralis major, serratus major, and rectus fascia | Â |
May be more surgical pain associated from the need to elevate pectoralis major, serratus major, and rectus fascia | Â |
All need a second surgery for TE exchanged to implant under another general anesthetic | Â |