Hematoma and deep surgical site infection following primary breast augmentation: A retrospective review of 1128 patients

Summery Background Breast augmentation is one of the most frequently performed cosmetic surgeries worldwide. Some of the most severe short-term complications after breast augmentation are hematoma and deep surgical site infection. However, these complications are relatively rare; therefore, large patient populations are required to perform statistical analyses. In this study, we provide a detailed analysis of the complications after primary breast augmentation with an emphasis on deep surgical site infection and hematoma. Method We retrospectively reviewed the medical records of women who underwent primary breast augmentation performed without the use of pocket irrigation between 2012 and 2019 in a single private clinic. A cumulative hazard function and a multivariate analysis on the risk of hematoma were performed. Results We included 1128 patients in the study. Thirty patients (2.7%) developed postoperative hematoma after a median time of 14 hours (IQR 5 hours-9 days). Six patients (0.5%) contracted a deep surgical site infection after a median time of 14 days (range 4-41 days). Neither age, BMI, implant volume or implant placement were significantly associated with hematoma. Conclusion Our findings support that the risk of hematoma after primary breast augmentation is highest within the first 24 hours after the surgery. This time period should be considered when planning postoperative care for these patients. We did not find an increased rate of deep surgical site infection compared with studies of breast augmentations with pocket irrigation. Further studies and meta-analyses are needed to explore the effect of pocket irrigation and other risk factors.