Simple prosthesis versus prosthesis plus titanium-coated polypropylene mesh for implant-based immediate breast reconstruction after total mastectomy for breast cancer

Abstract

Background: Our study compares the cosmetic effects, postoperative complications, and quality of life of immediate breast reconstruction with simple prosthesis or prosthesis plus titanium-coated polypropylene mesh (TCPM) after total mastectomy for breast cancer.Methods: In total, 69 patients who underwent total mastectomy, sentinel lymph node biopsy, and immediate prosthetic breast reconstruction from January 2015 to December 2018 in our hospital were selected, and their cosmetic effects, complications, and quality of life after reconstruction were recorded immediately after surgery and 6 months after surgery.Results: Of these 69 patients, 29 were in the simple prosthesis group and 40 in the prosthesis + TCPM group. The incidence of surgical complications was 17.2% in the simple prosthesis group (5/29; including 4 cases of capsular contracture and 1 case of infection) 15.0% in the prosthesis + TCPM group (6/40; 1 case of flap necrosis, 2 cases of poor wound healing, 2 cases of hematomas, and 1 case of inadequate blood supply to nipple). The complications were successfully managed after symptomatic treatment in both groups. No prosthesis loss was noted. The incidence of postoperative complications showed there to be no significant differences between these two groups (P=0.06, χ 2 =0.80). The satisfaction rate of patients on cosmetic effects was 95.0% (38/40) in the prosthesis + TCPM group, significantly higher than that in the simple prosthesis group (75.90%, 22/29) (P=0.05, χ 2 =3.87). The quality of life in the simple prosthesis group at 2 weeks and six months after the operation was significantly lower than that in the prosthesis + TCPM group. The incidence rate of arm pain and fatigue at 2 weeks after operation was significantly higher than that in the prosthesis + TCPM group (P=0.04, χ 2 =4.42). The satisfaction of family life and sexual interest 6 months after the operation was also significantly lower in the simple prosthesis group than in the prosthesis + TCPM group (P=0.03, χ 2 =4.95).Conclusions: Breast reconstruction with prosthesis combined with TCPM does not increase surgical complications and has a good cosmetic effect and high patient satisfaction. Thus, it is a safe and reconstruction method.

Application of TiLOOP bra in implant‐based breast reconstruction is associated with decreased complication risk compared with other meshes: A systematic review and meta‐analysis

“…11,21 Of the seven studies, three were 3-arm studies, including two studies comparing TiLOOP bra versus ADM versus partially absorbable synthetic mesh, 21,24 and one study comparing TiLOOP bra versus ADM versus simple prosthesis. 6 However, only two studies in our analysis reported BREAST-Q scores, both with available Physical Well-Being scale of the BREAST-Q data. 11,22 The risk of bias assessment result was presented in Supplemental Table S2.…”

“…A total of 182 publications were identified in the first search, of which seven studies met our inclusion criteria and were eligible for the present meta-analysis (Table 1). 6,11,[21][22][23][24][25] There was one prospective randomized controlled study, 23 the other six were retrospective studies. 6,11,21,22,24,25 Among these studies, there were four studies of one-stage reconstruction comparing the complication risk between TiLOOP bra and ADM, 6,22,23,25 the other three included both one and two-stage reconstruction.…”

“…6,11,[21][22][23][24][25] There was one prospective randomized controlled study, 23 the other six were retrospective studies. 6,11,21,22,24,25 Among these studies, there were four studies of one-stage reconstruction comparing the complication risk between TiLOOP bra and ADM, 6,22,23,25 the other three included both one and two-stage reconstruction. 11,21 Of the seven studies, three were 3-arm studies, including two studies comparing TiLOOP bra versus ADM versus partially absorbable synthetic mesh, 21,24 and one study comparing TiLOOP bra versus ADM versus simple prosthesis.…”

“…Among these studies, there were four studies of one‐stage reconstruction comparing the complication risk between TiLOOP bra and ADM, 6,22,23,25 the other three included both one and two‐stage reconstruction 11,21 . Of the seven studies, three were 3‐arm studies, including two studies comparing TiLOOP bra versus ADM versus partially absorbable synthetic mesh, 21,24 and one study comparing TiLOOP bra versus ADM versus simple prosthesis 6 . However, only two studies in our analysis reported BREAST‐Q scores, both with available Physical Well‐Being scale of the BREAST‐Q data 11,22 .…”

“…Synthetic meshes are knitted from different fibers, such as short‐term absorbable, long‐term absorbable, and non‐absorbable material (TiLOOP bra) 3,4 . According to a previous meta‐analysis, the overall complication rate of subpectoral IBBR was 21.5%, whereas the overall complication rate in prepectoral group was 17.5%, 5 and the incidence of capsular contractures was higher in the simple prosthesis group without mesh, which patient satisfaction was decreased 6 . In this way, using meshes in IBBR is a favored option, which might reduce postoperative complication risks while maintaining patient satisfaction.…”