Henriksen et al1 provided useful data on the short-term complications of breast reconstruction with implants. Although the invited critique described the complication rate as “alarmingly high and arguably unacceptable,” the complication rate is even higher in other studies with superior study designs.
For example, a study conducted by the implant manufacturer Inamed found that 46% of patients with reconstruction needed additional surgery within the first 2 to 3 years after getting silicone gel breast implants2—more than twice as high as the 21% reported by Henriksen et al. One explanation is that the women in the Henriksen et al study had breast implants for an average of only 23 months, compared with 2 to 3 years in the Inamed study. Henriksen et al reported that 31% developed at least 1 serious complication and 16% developed at least 2 serious complications. The Inamed study reported that 25% underwent implant removal, 16% experienced Baker III-IV capsular contracture, 6% experienced necrosis, 6% had breast pain, and 6% had scarring, in addition to infections and other complications.2