Immediate Breast Reconstruction (IBR) With Direct, Anatomic, Extra-Projection Prosthesis

Abstract

There are different methods described until now for immediate breast reconstruction. Despite the use of autologous flaps considered by many authors, implants are considered as an option by others. A prospective study of 102 clinical cases was designed, including a 1-year follow-up in which glands were reconstructed by immediate breast reconstruction (IBR) with direct, extra projection, anatomic prostheses located in a submuscular pocket after a skin-sparing mastectomy. The prosthesis coverage was made by the muscle in its upper two thirds and by using the skin from the mastectomy in its lower third. The cosmetic results obtained were evaluated according to the volume, form, and symmetry achieved using a linear numeric analogical score. This evaluation had an averaged value of 2.79 +/- 0.8 in our scale from poor (0) to excellent result (4). The overall rate of complications was 15.7% of the cases, with seroma being the most frequent. In conclusion, this preliminary study demonstrates that immediate breast reconstruction with a direct, extra projection, anatomic prosthesis is a good alternative. Nevertheless, more long-term studies with a higher number of patients and using an SF-36 for patient satisfaction are needed to confirm these results.

Immediate Breast Reconstruction After Skin- or Nipple-Sparing Mastectomy for Previously Augmented Patients: A Personal Technique

“…The necessity of finding an alternative to the total muscular coverage [24,25] of the expander/implant reconstruction that allows partial subpectoral positioning of the implant with preferential expansion of the lower pole has drawn different solutions. Strategies to address lowerpole expansion include suturing the inferior edge of the SWBr satisfaction with breast, SWO satisfaction with outcome, PWB psychosocial well-being, SWBe sexual well-being, PWBC physical wellbeing: chest, PWBA physical well-being: abdomen, SWN satisfaction with nipples, SWI satisfaction with information, S surgeon, MS medical staff, OS office staff pectoralis major muscle to the lower breast flap [6] or using marionette sutures of the inferior border of the pectoralis major muscle to cover most of the implant [26,27].…”

“…Radiotherapy adversely affects breast implants, resulting in a higher incidence of infection, extrusion, capsular contracture, and poor cosmetic results [4][5][6][7][8][9][10][11][12]. In fact, patients who undergo breast conservation therapy without removal of the implant can experience infection of the breast requiring removal of the irradiated implant or the breast deformity due to capsular contracture with implant displacement [13].…”

Tissue expansion for breast reconstruction: Methods and techniques

“…Indeed, extra-projected, anatomically-shaped prostheses filled with highly cohesive silicon gel can ensure outstanding cosmetic outcome as well as a safe surgical procedure, and thus help the patient avoid autologous breast reconstruction with its associated donor site morbidity [39], [40]. Even a large-breasted patient can be made eligible for implant-based, one-step reconstruction by means of skin reducing mastectomy [2].…”

Immediate Breast Reconstruction with Direct, Anatomic, Gel-Cohesive, Extra-Projection Prosthesis: 400 Cases

“…Approximately 20 percent of patients in our center have undergone mastectomies in conjunction with or without chemotherapy, hormone therapy, and radiotherapy. 1 A skin-sparing mastectomy is the removal of the nipple-areola complex, previous biopsy incisions, the entire mammary gland, the pectoral major fascia, and recumbent skin when a tumor is found near the surface. At the same time, the remaining skin covering the gland is conserved.…”