Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: First multicenter European report on 100 cases

Abstract

We report the outcomes of the European prospective study on prepectoral breast reconstruction using preshaped acellular dermal matrix for complete breast implant coverage. Seventy-nine patients were enrolled between April 2014 and August 2015 all over Europe using a single protocol for patient selection and surgical procedure, according to the Association of Breast Surgery and British Association of Plastic Reconstructive and Aesthetic Surgeons joint guidelines for the use of acellular dermal matrix in breast surgery. The preshaped matrix completely wraps the breast implant, which is placed above the pectoralis major, without detaching the muscle. A total of 100 prepectoral breast reconstructions with complete implant coverage were performed. This series, with mean follow-up of 17.9 months, had two cases of implant loss (2.0%) including one necrosis of the nipple and one wound breakdown (1.0% respectively). No implant rotations were observed. Good cosmetic outcomes were obtained with natural movement of the breasts and softness to the touch; none of the patients reported experiencing pain or reduction in the movements of the pectoralis major muscle postoperatively. The use of preshaped acellular dermal matrix for a complete breast implant coverage in selected patients is safe and gives satisfactory results, both from the aesthetic view point and the low postoperative complication rates. Further studies reporting long-term outcomes are planned.

Early multicentre experience of pre-pectoral implant based immediate breast reconstruction using Braxon®

“…In the prepectoral technique, operating time is reduced as it is a less complicated technique and the surgeon can begin to perform the ex vivo procedure of suturing the Braxon ® mesh (Figure 1) around the implant after the mastectomy, while haemostasis and irrigation of the prepectoral space are being carried out. Berna et al did not report any implant loss in their small series of 15 implant-based IBR using Braxon ® and Vidya et al in a series of 100 cases has demonstrated a very low implant loss rate of 2% (18,19). However, our complication rate of wound infection and implant loss were comparable to the NMBRA results which reported on subpectoral implant based reconstruction ( Table 3) (10).…”

Selective pectoralis major muscle denervation in breast reconstruction: a technical modification for more effective and cosmetic results

“…Recently, the long-term results of clinical studies on the pre-pectoral reconstructions by means of a synthetic matrix were published (11,12). Several other studies reported similar results with biological matrixes (8,(13)(14)(15)(16)(17)(18)(19). A pre-pectoral approach showed, in all these series, a highly documented surgical safety, comparable to the standard full muscular coverage and to the dual-plane coverage.…”

Multicentre study of prepectoral breast reconstruction using acellular dermal matrix

“…The past decade has seen a steady rise in implant and expander-based immediate breast reconstruction, from about 30 per cent in 2007 to 54 per cent in 2013 3 . Two recent multicentre European studies 13,18 reported acceptable operative outcomes, comparable to subpectoral reconstruction. Subpectoral implant placement has been the conventional method, with complete coverage of the implant using pectoralis major muscle above and acellular dermal matrix (ADM) in the lower and outer aspect.…”