Women with eczema or other atopic skin conditions may face greater risks of implant-related problems after breast reconstruction, according to a new study led by researchers in Texas. The findings highlight the need for surgeons to consider underlying inflammatory skin disorders when planning implant-based procedures.
Capsular contracture, a tightening of the scar tissue surrounding a breast implant, remains one of the most frequent and challenging complications following reconstruction. Well-known risk factors include infection, radiation, and certain patient characteristics, but the role of atopic diseases has been less understood. Since conditions like eczema and dermatitis involve skin barrier defects and immune system dysregulation, researchers suspected these factors might contribute to post-surgical inflammation or fibrosis.
Large Multi-Year Patient Analysis
Using national data from 2002 to 2022, the study identified female breast cancer patients aged 18 and older who underwent implant-based reconstruction. Participants were divided into two groups based on prior diagnoses of eczema, dermatitis, or allergic skin disorders. Researchers used propensity score matching to ensure both groups were comparable in terms of demographics, comorbidities, and cancer treatments such as radiation, chemotherapy, hormone therapy, and steroid use.
After matching, each group included 10,205 patients. Compared with those without atopic conditions, women with skin allergies had a 20% higher risk of overall implant complications and capsular contracture at two and three years after surgery. They also experienced higher rates of revision surgeries, implant removal, and rupture, with infection risk elevated at every follow-up point.
Implications for Surgical Planning
The authors conclude that preexisting atopic skin disease is a significant yet underrecognized risk factor for implant-related complications in breast reconstruction. The findings suggest surgeons should include dermatologic history in preoperative assessments and discuss the potential for higher complication rates with affected patients.
By identifying at-risk groups, clinicians can better tailor surgical strategies, optimize post-operative management, and improve long-term outcomes for breast cancer patients undergoing reconstruction.
Reference
Nguyen P et al. Association between atopic skin disease and implant-related complications in breast reconstruction. ACAAI Annual Scientific Meeting. Abstract R290. November 6-10 2025.
