Objective To analyze the complications after breast cancer implant reconstruction and explore the application value of retaining the prosthesis in case of infection after breast cancer implant reconstruction.

Methods A total of 110 cases of breast cancer implant reconstruction and their clinical data from 2017 to 2022 in the Affiliated Tumor Hospital of Guangzhou Medical University were collected, including postoperative complications, timing of reconstruction, tumor treatment methods, and basic clinical information. The incidence of complications and their influencing factors were analyzed, and the treatment methods for complications were further explored.

Results There was no statistical difference in the incidence of postoperative complications among chemotherapy, endocrine therapy, targeted therapy, and axillary lymph node dissection. Patients with a body mass index (BMI) ＞ 25 kg/m² have a higher incidence of postoperative complications. There was no significant difference in the incidence of postoperative complications between patients with and without radiotherapy (radiotherapy: 49 cases vs. no radiotherapy: 61 cases). Conservative treatment with retaining the prosthesis was effective for the infection after breast cancer prosthesis reconstruction. There were significant differences between preoperative and postoperative muscle parameters — specifically cross-sectional area (CSA) and computed tomography (CT) attenuation values — in breast implant placement surgery.

Conclusion The complications after breast cancer implant reconstruction are clinically controllable. Postoperative radiotherapy is not an absolute contraindication for primary reconstruction. Implant infection can be controlled by conservative treatment to retain the prosthesis. The incidence of pectoralis major muscle atrophy on the affected side after subpectoral breast cancer implant implantation is high.