Citation: Plastic & Reconstructive Surgery. 2018 Dec 24.Journal: Plastic and reconstructive surgery.Published: ; 2018ISSN: 0032-1052.Full author list: Black CK; Graziano FD; Fan KL; Defazio MV; Nahabedian MY.UI/PMID: 30589827.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment(s): Surgery/Plastic SurgeryActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1097/PRS.0000000000005373 (Click here)Abbreviated citation: Plast Reconstr Surg. 2018 Dec 24.Abstract: BACKGROUND: Implants offer a method for augmenting abdominal flaps in the setting of deficient volume in breast reconstruction. They may be placed immediately at the time of reconstruction or on a delayed basis. We seek to compare outcomes from a single surgeon and previously published studies.Abstract: METHODS: A systematic review was performed, querying multiple databases. A retrospective review was conducted for patients who underwent abdominal based flap breast reconstruction and implant placement between July 2005 and August 2015 by the senior author(MYN).Abstract: RESULTS: A systematic review of the literature yielded four articles, for a total of 96 patients(142 breasts) included for systematic review. 87 breasts(61%) were reconstructed with immediate implant at the time of flap reconstruction and 55 breasts(39%) had a staged approach to implant placement. Complications were noted in 28 breasts(32%) following immediate placement and in 10 breasts(18%) following staged placement. A total of 53 patients(79 breasts) were retrospectively reviewed, all of which were reconstructed in a staged manner. Twelve breasts(15%) were found to have a flap or implant related complication. 97.5% of implants/flap reconstructions were successful, with a 54% revision rate. When pooling systematic and retrospective data, there was a significant difference in complication rates between the staged and immediate reconstruction cohorts(p < 0.001) in favor of the staged approach.Abstract: CONCLUSIONS: The literature supports a higher rate of implant-related complications following immediate implantation at the time of flap reconstruction. Our experience with implant placement highlights the safety and effectiveness of the staged approach.