Breast Reconstruction in Patients with Prior Breast Augmentation: Searching for the Optimal Reconstructive Option

Breast cancer in patients with prior breast augmentation poses unique challenges for detection, diagnosis, and management. Mastectomy rates are increasing, and patients with prior augmen-tation often have a lower body mass index, making autologous techniques unsuitable. This study aims to assess the best reconstructive option in patients with a history of subglandular or dual plane breast augmentation. Materials and methods: a prospective analysis was conducted on pa-tients who underwent breast reconstruction after mastectomy. Patients with subglandular or dual plane breast augmentation were included. Patients were divided into submuscular breast recon-struction (group 2) or prepectoral breast reconstruction (group 1) groups. Demographic and sur-gical data were collected. Results: A total of 47 patients were included, with 23 in Group 1 and 24 in the Group 2. Complications occurred in 11 patients (23.4%), with significant differences be-tween groups. The most common complication was seroma formation. Implant loss occurred in 4.3% of cases in the Group 1, while no implant loss was observed in the Group 2. Patient-reported satisfaction scores were similar between groups at 12 months postoperatively. Conclusions: sub-pectoral breast reconstruction with a tissue expander seems a safer and effective technique for pa-tients with prior breast augmentation. It resulted in fewer complications. This approach should be considered as an option for breast reconstruction after mastectomy in this cohort of patients.