Atopic Disease As A Risk Factor For Implant-related Complications In Breast Reconstruction

Philong Nguyen, Doruk Orgun, Yousef Tanas, Myiah Quach, Joshua Wang, Samuel O. Poore

Keywords: atopic disease, breast reconstruction, implant complications, capsular contracture, capsulectomy, implant removal, mastodynia, eczema, asthma, allergic rhinitis, dermatitis, propensity score matching, TriNetX, plastic surgery, reconstructive surgery

Abstract:

Capsular contracture is one of the most common complications of implant-based breast reconstruction. This study evaluated whether preexisting atopic disease, including eczema, asthma, allergic rhinitis, and dermatitis, is associated with increased implant-related complications following breast reconstruction.

Using a TriNetX query of over 158 million patients across 111 healthcare organizations from 2016 to 2022, we identified female patients who underwent implant-based breast reconstruction. After propensity score matching, 5,280 patients remained in each cohort. At three years, atopic patients had significantly higher rates of implant removal (19.22% vs 17.24%; HR 1.13), peri-implant capsulectomy (11.37% vs 9.91%; HR 1.16), and mastodynia (12.72% vs 9.55%; HR 1.36). No significant differences were found in capsular contracture, mechanical complications, or breast revision.

Atopic disease represents an independent risk factor for secondary surgical intervention following implant-based breast reconstruction. The underlying mechanisms remain unclear, as capsular contracture does not appear to be the primary driver. Prospective studies are needed to confirm this association and identify causative pathways.

Institutions: University of Texas Medical Branch, University of Wisconsin Division of Plastic Surgery, Houston Methodist Hospital, Weill Cornell Medicine