WTP6.09 Current Practices and Outcomes in Breast Reconstruction After Augmentation: A Systematic Review

Abstract Introduction The increasing prevalence of breast augmentation procedures has resulted in a growing population of patients requiring breast reconstruction following mastectomy. These cases present challenges due to anatomical alterations and heightened aesthetic expectations. Understanding the outcomes of different reconstruction techniques in augmented versus non-augmented patients is critical to guide clinical decision-making. Methods A PRISMA-compliant systematic review was conducted, including articles from inception to December 2024. Data on reconstruction techniques, including implant-based and autologous reconstruction, were synthesised through narrative analysis. Special emphasis was placed on comparing augmented and non-augmented cohorts. Results A total of 28 studies were included in the analysis. The review identified implant-based reconstruction as the most frequently utilised approach in patients with prior augmentation. Submuscular implant positioning and the use of acellular dermal matrices were commonly employed to optimise surgical outcomes. Autologous reconstruction, although performed less often, was associated with enhanced aesthetic results in select cases. However, decisions regarding the retention or removal of pre-existing implants during reconstruction were inconsistently reported, reflecting a lack of standardised practices. Comparisons between augmented and non-augmented cohorts were hindered by small sample sizes and inconclusive evidence, particularly in relation to long-term complications, patient satisfaction, and overall outcomes. Conclusion Breast reconstruction in patients with prior augmentation presents distinct challenges but can achieve favourable outcomes with appropriate techniques. Implant-based approaches are often preferred, although autologous options remain valuable in specific contexts. Further research with larger cohorts and standardised protocols is essential to optimise reconstruction strategies and improve long-term outcomes for this growing patient population.