American Association of Plastic Surgeons

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Impact Of Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) On Postoperative Complication Rates In Immediate Prosthetic Based Breast Reconstruction: A Retrospective Cohort Study
Anshumi Desai, MD1, Emily Finkelstein, MD1, Iago De Castro- Silva, MD2, Meaghan Clark, BS3, Susan B Kesmodel, MD FACS1, Kristin E Rojas, MD FACS1, Devinder Singh, MD1, Kyle Xu, MD1, Juan R Catinchi-Mella, MD MPH1
1University of Miami, Miami, FL, USA, 2University of South Florida, Tampa, FL, USA, 3Ross University, Bridgetown, Barbados

Lymphatic Microsurgical Preventative Healing Approach (LYMPHA) is performed at the time of axillary lymph node dissection (ALND) reducing rate of lymphedema (LE). It is often performed with immediate Implant-Based Breast Reconstruction (IBBR). We aimed to determine whether the additional LYMPHA procedure impacts surgical outcomes of IBBR.
METHODS: A retrospective cohort study included breast cancer patients undergoing Mastectomy with IBBR (with and without ALND with LYMPHA (April 2021 -May 2023). Complications recorded were hematoma, seroma, minor infection (requiring oral antibiotics), major infection (requiring intravenous antibiotics), wound dehiscence, mastectomy flap necrosis, implant exposure, and readmission within 90 days of surgery.
77 patients met inclusion criteria: 48% (n=37) had IBBR with LYMPHA and 52% (n=40) had IBBR without LYMPHA. Table 1 shows demographic characteristics.

The complication rates in both cohorts are shown in Figure 1.

None of the complications showed a statistically significant difference between the two cohorts. The overall complication rates had no statistically significant difference between the two cohorts(29.7 % vs 12.5 %, p=0.06).
The study showed no statistically significant differences in complications between IBBR patients with or without LYMPHA, indicating that LYMPHA does not increase postoperative risks.

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