Paraphrased from Plastic and Reconstructive Surgery, Jun 2017:

The case for Autologous Breast Reconstruction rather than Implant Reconstruction in Irradiated Patients.

Methods: From the 2009 to 20130, irradiated breast cancer patients who underwent implant or autologous reconstruction were selected.

Results: There were 2964 study patients. Most (78 percent) underwent implant reconstruction. The unadjusted mean costs for implant and autologous reconstructions were $22,868 and $30,527, respectively.

Thirty-two percent of implant reconstructions failed, compared with 5 percent of autologous cases.

Twelve percent of the implant reconstructions had two or more failures and required subsequent autologous reconstruction.

The cost of implant reconstruction failure requiring a flap was $47,214, and the cost for autologous failures was $48,344.

In aggregate, failures constituted more than 20 percent of the cumulative costs of implant reconstruction compared with less than 5 percent for
autologous reconstruction.

Conclusions: More than one in 10 patients who had implant reconstruction in the setting of radiation therapy to the breast eventually required a flap for failure.

These findings make a case for autologous reconstruction being primarily considered in irradiated patients who have this option available.

Reference:
Comparing Health Care Resource Use between Implant and Autologous Reconstruction of the Irradiated Breast: A National Claims-Based Assessment

Aliu, Oluseyi M.D., M.S.; Zhong, Lin M.D., M.P.H.; Chetta, Matthew D. M.D.; Sears, Erika D. M.D., M.S.; Ballard, Tiffany M.D.; Waljee, Jennifer
F. M.D., M.S.; Chung, Kevin C. M.D., M.S.; Momoh, Adeyiza O. M.D.

Plastic & Reconstructive Surgery: June 2017 - Volume 139 - Issue 6 - p 1224e–1231e