Skin-Reduction Breast Reconstructions with Prepectoral Implant

Caputo, Glenda Giorgia; Marchetti, Alberto; Pozza, Edoardo Dalla; Vigato, Enrico; Domenici, Lavinia; Cigna, Emanuele; Governa, Maurizio

doi:10.1097/prs.0000000000002227

Cited by 88 publications

(84 citation statements)

References 17 publications

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“…Two articles were excluded; one was a literature review, and the other reported data included in another study. Final screening yielded 14 studies published between 2014 and 2016, including four observational studies comparing pre‐pectoral and dual‐plane reconstruction . Four were congress abstracts, including one in which five authors (A.G., S.S., M.P., L.G., D.M.)…”

Section: Resultsmentioning

confidence: 99%

“…Four were congress abstracts, including one in which five authors (A.G., S.S., M.P., L.G., D.M.) were investigators, and the remaining were peer‐reviewed journal articles (Table ) …”

Section: Resultsmentioning

confidence: 99%

“…Pre‐pectoral breast reconstruction is an emerging technique whereby the implant is placed above the pectoralis major muscle with the assistance of ADM . Early outcomes with pre‐pectoral reconstruction have demonstrated short recovery times with, depending upon the skill of the surgeon, natural breast contour and position . Questions regarding the lack of muscle coverage and its relationship to long‐term capsular contracture risk remain .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early assessment of post‐surgical outcomes with pre‐pectoral breast reconstruction: A literature review and meta‐analysis

Chatterjee

Nahabedian

Gabriel

et al. 2018

Journal of Surgical Oncology

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Section: Resultsmentioning

confidence: 99%

“…Four were congress abstracts, including one in which five authors (A.G., S.S., M.P., L.G., D.M.) were investigators, and the remaining were peer‐reviewed journal articles (Table ) …”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early assessment of post‐surgical outcomes with pre‐pectoral breast reconstruction: A literature review and meta‐analysis

Chatterjee

Nahabedian

Gabriel

et al. 2018

Journal of Surgical Oncology

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show abstract

“…For example, even though the number of implant-based reconstructions has increased dramatically in the past 10 years (Albornoz et al, 2013), surgeons lack evidence from randomized controlled trials to help women identify the best implant (e.g., silicone vs. saline, variable-volume vs. fixed-volume) (Rocco et al, 2016). Providers need patient-reported outcomes data to help them evaluate new reconstruction methods (e.g., prepectoral implants) (Caputo et al, 2016). Second, women have a short time frame in which to make their decision about whether to undergo immediate versus delayed reconstruction as well as what type of reconstruction to undergo.…”

Section: Discussionmentioning

confidence: 99%

Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Steffen

Johnson

Levine

et al. 2017

Plastic Surgical Nursing

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Background The purpose of this study was to evaluate the prevalence of met and unmet expectations after breast reconstruction among breast cancer survivors following mastectomy. A secondary objective was to examine women’s reasons their experiences of reconstructive surgery were better or worse than expected. Methods As part of a larger study of breast cancer survivors, participants completed self-administered questionnaires within 8 months of diagnosis and at 6, 12, and 18 months later. At the 18-month follow-up, women who had breast reconstruction were asked whether their reconstruction was better, the same, or worse than expected. Results The sample consisted of 130 survivors (mean age 48.5 years) who had breast reconstruction following a mastectomy and completed the 18-month follow-up, 42% of whom reported their reconstruction was worse than expected and only 25% reported it was better. Most frequently reported reasons for reconstruction being worse than expected were related to appearance of the reconstructed breast and pain. Conclusions A high percentage of breast cancer patients undergoing breast reconstruction following a mastectomy report the results as worse than expected with the primary reasons for dissatisfaction related to the feel and appearance of the reconstructed breast. Breast cancer patients considering breast reconstruction need better pre-operative education or understanding about what to expect from reconstruction.

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“…Recently, several small studies investigated the complication rates in subcutaneous placement. Data are not conclusive as complication rates largely vary (explantation ranges from 0 to 18%, seroma 2-23%, nipple or skin necrosis 1-28%) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. There are three main reasons for this big variance:…”

Section: Introductionmentioning

confidence: 99%

Surgeon’s preference of subcutaneous tissue resection: most important factor for short-term complications in subcutaneous implant placement after mastectomy—results of a cohort study

Pfob

Koelbel

Schuetz

et al. 2020

Arch Gynecol Obstet

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Purpose Little is known about the reason of high short-term complication rates after the subcutaneous placement of breast implants or expanders after mastectomy without biological matrices or synthetic meshes. This study aims to evaluate complications and their risk factors to develop guidelines for decreasing complication rates. Methods We included all cases of mastectomy followed by subcutaneous implant or expander placement between 06/2017 and 05/2018 (n = 92). Mean follow-up time was 12 months. Results Explantation occurred in 15 cases (16.3%). The surgeon's preference for moderate vs. radical subcutaneous tissue resection had a significant influence on explantation rates (p = 0.026), impaired wound healing or infection (requiring surgery) (p = 0.029, p = 0.003 respectively) and major complications (p = 0.018). Multivariate analysis revealed significant influence on complication rates for radical subcutaneous tissue resection (p up to 0.003), higher implant volume (p up to 0.023), higher drain volume during the last 24 h (p = 0.049), higher resection weight (p = 0.035) and incision type (p = 0.011). Conclusion Based on the significant risk factors we suggest the following guidelines to decrease complication rates: favoring thicker skin envelopes after surgical preparation, using smaller implants, removing drains based on a low output volume during the last 24 h and no use of periareolar incision with extension medial or lateral. We should consider ADMs for subcutaneous one-stage reconstructions. The individual surgeon's preference of subcutaneous tissue resection is of highest relevance for short-term complicationsthis has to be part of internal team discussions and should be considered in future trials for comparable results.

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Skin-Reduction Breast Reconstructions with Prepectoral Implant

Abstract: Therapeutic, IV.

Cited by 88 publications

References 17 publications

Early assessment of post‐surgical outcomes with pre‐pectoral breast reconstruction: A literature review and meta‐analysis

Early assessment of post‐surgical outcomes with pre‐pectoral breast reconstruction: A literature review and meta‐analysis

Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Surgeon’s preference of subcutaneous tissue resection: most important factor for short-term complications in subcutaneous implant placement after mastectomy—results of a cohort study

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