A systematic review of complications in prepectoral breast reconstruction

Wagner, Ryan D.; Braun, Tara L.; Zhu, Huirong; Winocour, Sebastian

doi:10.1016/j.bjps.2019.04.005

Cited by 78 publications

(73 citation statements)

References 43 publications

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“…Upon subgroup analysis, however, the rate of capsular contracture with the use of ADM was decreased to 2.3% as compared to 12.4% without. 15 While lending to lower capsular contracture and overall complications rates, the use of ADM was correlated with a higher rate of implant loss, infection, and mastectomy flap necrosis. 15 ADM is also associated with red breast syndrome with an incidence of 6.4%.…”

Section: Complicationsmentioning

confidence: 95%

“…15 While lending to lower capsular contracture and overall complications rates, the use of ADM was correlated with a higher rate of implant loss, infection, and mastectomy flap necrosis. 15 ADM is also associated with red breast syndrome with an incidence of 6.4%. 16 This entity is characterized by erythema directly overlying the ADM and is thought to be secondary to lymphedema and lymphatic obstruction postoperatively.…”

Section: Complicationsmentioning

confidence: 95%

“…Nevertheless, the prepectoral approach is not without its drawbacks as well. 14,15 The most common complication is capsular contracture with a rate of 8.8% in a recent systematic review of prepectoral breast reconstruction complications. Upon subgroup analysis, however, the rate of capsular contracture with the use of ADM was decreased to 2.3% as compared to 12.4% without.…”

Section: Complicationsmentioning

confidence: 99%

“…Meticulous hemostasis and thoughtful drain placement help to mitigate these risks. 15 Another concern is the risk of visible implant rippling at the upper pole given thinner soft tissue coverage as compared to submuscular reconstruction. During twostage prepectoral reconstruction, the tissue expanders should be underfilled relative to the anticipated final implant size in order to avoid rippling due to redundant skin during the expander-to-implant exchange operation.…”

Section: Dovepressmentioning

confidence: 99%

See 3 more Smart Citations

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

Bloom¹,

Patel²,

Cohen³

et al. 2020

OAS

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Prepectoral breast reconstruction is an increasingly prevalent form of breast reconstruction. Prepectoral breast reconstruction was abandoned in the past due to various complications but has recently made a resurgence due to the development of acellular dermal matrices and innovative techniques. The purpose of this review article is to discuss the history, techniques, benefits, and potential complications of prepectoral breast reconstruction. The article also reviews current literature to evaluate published complication rates. Complications evaluated include infection (3.67%), wound dehiscence (2.10%), skin necrosis (3.67%), seroma (2.89%), hematoma (1.34%), implant loss (3.28%), return to the OR (6.15%), contracture (3.61%), and rippling (7.38%). In conclusion, prepectoral breast reconstruction is a reliable, safe, and aesthetically feasible method of breast reconstruction. With increasing interest in this technique, it is important that surgeons and patients are familiar with prepectoral reconstruction and this article aims at providing this information.

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Section: Complicationsmentioning

confidence: 95%

Section: Complicationsmentioning

confidence: 95%

Section: Complicationsmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

See 2 more Smart Citations

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

Bloom¹,

Patel²,

Cohen³

et al. 2020

OAS

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“…Studies have reported significantly lower rates of capsular contracture with the use of ADM than without it, but the length of the follow-up is short [20]. Although no high-quality study has directly compared the incidence of capsular contracture between synthetic and biological matrices IBBR, rates are similar for both types (1.3-8.6% for meshes and 0.4-8.1% for matrices) [1, 3, 28,29]. Dieterich et al [30] reported a histological analysis with mild inflammation using TiLOOP, suggesting a low risk of capsular contracture.…”

Section: Complicationsmentioning

confidence: 99%

Synthetic Mesh in Immediate Breast Reconstruction

Gómez-Modet¹,

Tejedor²

2020

Breast Cancer and Breast Reconstruction

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The use of biological matrices in immediate implant-based breast reconstruction arose with the need to reinforce the lower pole of the breast and to cover the implant to reduce the risk of implant exposure. Synthetic mesh appears to be a lower cost alternative to biological matrices. This literature review aims to assess the usefulness of the use of synthetic meshes in breast reconstruction compared with the traditional techniques and whether outcomes and complications of synthetic meshes and biological matrices are comparable. The positioning of the implants and meshes, either submuscular or subcutaneous, has also been considered.

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Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort

Dave

Vucicevic

Barrett

et al. 2021

British Journal of Surgery

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Background Prepectoral implant-based breast reconstruction with acellular dermal matrix has become an increasingly popular option for selected patients. There are no randomized data to demonstrate short- or long-term outcomes. Cohort studies to date have demonstrated safety, but risk factors for complications are unknown. Methods A prospective cohort study of all patients undergoing prepectoral implant-based breast reconstruction between 2013 and 2019. Clinical factors and those related to reconstruction were analysed in relation to complications and implant loss using univariable and multivariable logistic regression. Results A total of 469 reconstructions were undertaken in 289 women; the majority of reconstructions were performed using a one-stage direct-to-implant technique with acellular dermal matrix. Median follow-up was 21 (range 2–71) months. Minor complications were seen after 11·2 per cent of reconstructions, major complications after 5·9 per cent, and the rate of implant loss by 3 months was 3·1 per cent. In the final multivariable model, sentinel node biopsy (odds ratio (OR) 5·06, 95 per cent c.i. 2·00 to 12·80), axillary clearance (OR 6·67, 1·17 to 37·94) and adjuvant radiotherapy (OR 7·11, 1·60 to 31·61) were independent risk factors for development of a major complication, and sentinel node biopsy (OR 4·32, 1·23 to 15·22) for implant loss. Conclusion Prepectoral implant-based breast reconstruction has acceptable medium-term results but careful patient selection is advised.

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A systematic review of complications in prepectoral breast reconstruction

Cited by 78 publications

References 43 publications

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

<p>Prepectoral Breast Reconstruction: An Overview of the History, Technique, and Reported Complications</p>

Synthetic Mesh in Immediate Breast Reconstruction

Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort

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