Prepectoral direct-to-implant breast reconstruction with complete ADM or synthetic mesh coverage – 36-Months follow-up in 200 reconstructed breasts

The largest multicentre data collection on prepectoral breast reconstruction: The iBAG study

“…The study by Reitsamer et al on 200 PPBR with implants wrapped either with ADM or synthetic mesh showed the following complication rate among the total reconstructed breasts in a 36‐months follow‐up: 7% of necrosis, 4% of hematoma, 14.5% of seroma, 2.5% of implant rotation and 1.5% of rippling; lipofilling was required in 3.5% of the women. Although complication rates in this study were quite higher than those reported in the iBAG study, we are not able to associate them specifically with one of the two materials used to cover the implant, since the authors did not correlate outcomes with membrane type 14 . Instead, we are led to consider the surgical approach chosen as the critical factor impacting outcomes, since 79.5% of cases underwent mastectomy through inframammary fold incision versus 13% of iBAG experience.…”

The iBAG study—a milestone?

“…As our results were discussed in this paper by Masià, we want to clarify, that we did 200 nipple-sparing mastectomies with singlestage direct-to-implant breast reconstructions. 2 Masià reported on 1450 operated breasts, but only 49.7%, 720 breasts were nipplesparing mastectomies. Masià mentioned our complication rates to be quite higher than those reported in the iBAG study.…”

“…In general, we are the proponents and advocates for prepectoral implant based breast reconstruction after nipple-sparing mastectomy and promote the further implementation of this method 4 -but iBAG a milestone? Roland Reitsamer 1 Florentia Peintinger 2,3 Frederike Klaassen-Federspiel 1 Andreas Sir 1 1 Department of Senology, University Hospital Salzburg,…”

Synthetic Mesh in Immediate Breast Reconstruction

“…A recent cohort study reported no differences in satisfaction and quality of life between the use of matrix (Surgisis) or mesh (TIGR) in IBBR [41]. Reitsemer et al reported low complication rates after 200 prepectoral reconstructions with the use of ADM or TIGR mesh, but with no comparison between both [42]. A systematic review comparing subcutaneous IBBR using ADM or meshes (without any information about the types of meshes) concluded that short-term complication rates are low and similar but refers that statistical analysis was not possible given differing study designs, confounding variables, and lack of comparative data in each study [43].…”