Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy

Sbitany, Hani; Piper, Merisa; Lentz, Rachel

doi:10.1097/prs.0000000000003627

Cited by 243 publications

(166 citation statements)

References 33 publications

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“…these deformities is autologous fat grafting [13,30,34,35]. Advances in fat grafting techniques have made fat grafting a routine procedure in breast surgery [30].…”

mentioning

confidence: 99%

Prepectoral breast reconstruction

Kim

2019

Yeungnam Univ J Med

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Implant-based breast reconstruction is the most commonly used reconstruction technique after mastectomy. This is because skin-sparing mastectomy has become possible with advancements in oncology. In addition, the development of breast implants and the advent of acellular dermal matrices have reduced postoperative complications and resulted in superior cosmetic results. The most frequently performed surgical breast reconstruction procedure for the past 20 years was the insertion of an implant under the pectoralis major muscle by means of the dual plane approach. However, some patients suffered from pain and animation deformity caused by muscle manipulation. Recently, a prepectoral approach has been used to solve the above problems in select patients, and the results are similar to subpectoral results. However, this technique is not always chosen due to the number of considerations for successful surgery. In this article, we will discuss the emergence of prepectoral breast reconstruction, indications and contraindications, surgical procedures, and outcomes.

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“…these deformities is autologous fat grafting [13,30,34,35]. Advances in fat grafting techniques have made fat grafting a routine procedure in breast surgery [30].…”

mentioning

confidence: 99%

Prepectoral breast reconstruction

Kim

2019

Yeungnam Univ J Med

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“…1 Implant-based reconstruction has been the most used technique for post-mastectomy breast reconstruction, 2 mainly in the form of submuscular or dual plane (partial submuscular) implant placement. 3 With the development of acellular dermal matrix (ADM) for soft tissue coverage, prepectoral breast reconstruction has become a more viable alternative. This review aims to discuss the history, techniques, benefits, and potential complications of prepectoral breast reconstruction.…”

Section: Introductionmentioning

confidence: 99%

“…The advances in both ADM and implant technology have made prepectoral breast reconstruction approach an attractive option from a reconstructive standpoint. ADM appears to decrease the rates of capsular contracture, 3,4 results in a more natural, aesthetically pleasing breast shape, and increases the success rate of prepectoral breast reconstruction by providing another layer of soft tissue coverage between the implant and mastectomy skin flaps. Similarly, newer generation cohesive silicone implants may reduce implant rippling and visibility.…”

Section: Introductionmentioning

confidence: 99%

“…The implant is then inserted, and the ADM is sutured inferiorly. 5,9 Alternatively, another approved approach involves wrapping the ADM completely around the implant or expander, as described by Sbitany et al 3 . The ADM is first shaped to the size of the implant/expander (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

“…A 2-3 cm cuff of ADM is sutured at the level of the desired inframammary fold (IMF) in 2 suture rows (Figure 4), the implant/expander is then placed on the surface of the pectoralis muscle and the ADM is wrapped around the device and sutured circumferentially ( Figure 5). 3,5,10 The complete wrap is not only more expensive owing to its use of a larger sheet of ADM but data have shown higher incidence of implant loss, capsular contracture, rippling, seroma, and flap necrosis. 11 The presence of ADM usually leads to seroma formation and thus one to two drains are typically placed in each breast.…”

Section: Introductionmentioning

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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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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Effect of Immediate Implant-Based Breast Reconstruction After Mastectomy With and Without Acellular Dermal Matrix Among Women With Breast Cancer

et al. 2021

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IMPORTANCE The use of acellular dermal matrix (ADM) in implant-based breast reconstructions (IBBRs) is established practice. Existing evidence validating ADMs proposed advantages, including improved cosmetics and more single-stage IBBRs, is lacking. OBJECTIVE To evaluate whether IBBR with ADM results in fewer reoperations and increased healthrelated quality of life (HRQoL) compared with conventional IBBR without ADM. DESIGN, SETTING, AND PARTICIPANTS This was an open-label, multicenter, randomized clinical trial of women with primary breast cancer who planned for mastectomy and immediate IBBR, with a 2-year follow-up for all participants. Participants were enrolled at 5 breast cancer units in Sweden and the United Kingdom between 2014 and May 2017. Exclusion criteria included previous radiotherapy and neo-adjuvant chemotherapy. Data were analyzed until August 2017. INTERVENTIONS Participants were allocated to immediate IBBR with or without ADM. MAIN OUTCOMES AND MEASURES The primary trial end point was number of reoperations at 2 years. HRQoL, a secondary end point, was measured as patient-reported outcome measures using 3 instruments from the European Organization for Research and Treatment of Cancer Quality of life Questionnaire.

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Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy

Abstract: Therapeutic, III.

Cited by 243 publications

References 33 publications

Prepectoral breast reconstruction

Prepectoral breast reconstruction

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

Effect of Immediate Implant-Based Breast Reconstruction After Mastectomy With and Without Acellular Dermal Matrix Among Women With Breast Cancer

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