Evaluation of Major Complications Following Ruptured Implant Removal: A National Surgery Quality Improvement Program Database Analysis.

Abstract

After the removal of ruptured breast implants, patients may elect to replace or not replace ruptured implants. They also may elect to undergo mastopexy alone without replacement of breast implants to maintain a more aesthetic shape of the breast after ruptured implant removal. The objective of this study was to cultivate an understanding of demographic differences in patient populations who opted for various surgical options at the time of ruptured implant removal. We hypothesized that procedures performed at the time of ruptured breast implant removal had a favorable complication profile. Utilizing the American College of Surgeons' National Surgery Quality Improvement Program (NSQIP) database (2011-2022), surgeries performed at the same time of ruptured breast implant removal (CPT 19330) were analyzed. To capture cosmetic patients, any patient with an ICD or CPT code related to breast cancer was excluded. Patients with implant replacement were identified with appropriate CPT codes. For those who did not undergo implant replacement, a subgroup was created for those who underwent mastopexy. Demographics and complication rates between groups were compared with Welch's t tests or chi-square tests. The majority (54.9%; 1662/3028) of patients elected to have new implants placed. Of those who did not undergo implant replacement, 12.2% (167/1366) had a mastopexy. Regardless of whether the patient chose to replace implants or undergo mastopexy, there were low complication rates, including infection (0.9%-2.4%), abscess (0.0%-1.4%), dehiscence (0.3%-0.5%), and bleeding (0.0%-0.6%). Rates of reoperation (1.2%-1.8%) and readmission (0.0%-1.8%) also were low. Removal of ruptured implants is a safe procedure, with low levels of complication, regardless of whether the patient chooses to replace or not to replace ruptured implants.