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Aesthetic and Oncologic Outcomes After Reconstructive Breast Augmentation following Lumpectomy: A Propensity Controlled Study
Rebecca Lisk, Thomas J. Sorenson, Lauren E. Romanowski
*, Carter Boyd, Chris Amro, Mihye Choi, Nolan S. Karp, Oriana Cohen
Hansjorg Wyss Department of Plastic Surgery, New York University-Grossman School of Medicine, New York, NY
BackgroundBreast augmentation is increasingly performed after breast conserving therapy to restore symmetry and improve aesthetic outcomes, yet limited contemporary data exist regarding revision burden, complication rates, and oncologic safety in this population.
MethodsA retrospective cohort study was performed using the Epic COSMOS database. Adult female patients undergoing breast lumpectomy followed by reconstructive augmentation between 2017 and 2025 were identified. Demographic data were collected, and aesthetic, oncologic, and surgical outcomes were measured and reported. Comparison of oncologic outcomes between augmented patients and non-augmented patients was performed using propensity score matching to adjust for covariates.
ResultsA total of 3,744 female patients that underwent breast lumpectomy followed by augmentation were included. Mean (SD) age was 56 (11.7) years and mean BMI was 26.4 (6). Most patients had a history of radiation (87%). Within 36 months, 24% (909/3,744) of patients underwent at least one revision procedure with a mean (SD) of 1.4 (0.8) revision. Breast tumor recurrence or new cancer occurred in 5.6% (211/3,744) of patients. Stage progression was rare (1%), and new metastatic disease occurred in 0.2% of patients. Compared to a propensity-matched non-augmented cohort, augmented patients demonstrated comparable rates of recurrence without an increase in advanced disease.
ConclusionsBreast augmentation following lumpectomy is associated with a substantial revision burden. Despite this, oncologic outcomes appear comparable to non-augmented patients with no increase in advanced disease and low rates of stage progression. These findings support the oncologic safety of augmentation after breast-conserving therapy while emphasizing the need for careful patient counseling regarding revision risk.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
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Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
