Visualized pre- and subpectoral implant placement for immediate breast reconstruction

Dyrberg, Diana L.; Bille, Camilla; Gunnarsson, Gudjon Leifur; Sørensen, Jens Ahm; Thomsen, Jørn Bo

doi:10.21037/gs.2019.05.09

Cited by 6 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The direct-to-implant technique for subpectoral implant placement we used has been described in a recent publication [12] and illustrated in another recent publication [13]. The inferomedial insertion of the PMM was released and a biological mesh was sutured by 2-0 absorbable sutures laterally and along the inframammary crease to create the implant pocket.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background A high incidence of breast animation deformity (BAD) has been reported following immediate breast reconstruction with subpectorally placed implants. The aim of this study was to assess and compare the incidence of BAD in women who underwent either subpectoral or prepectoral immediate breast reconstruction. Therefore, we developed a grading tool and tested its reproducibility in a clinical setting. Methods Video recordings of 37 women who had undergone unilateral or bilateral immediate breast reconstruction were evaluated by two consultant plastic surgeons. The degree of BAD was assessed by our grading tool, named the Nipple, Surrounding Skin, Entire Breast (NSE) grading scale, which evaluates the degree of tissue distortion in three areas of the breast. Blinded assessments were performed twice by each observer. Results Eighteen patients were reconstructed with subpectoral implant placement and 19 with prepectoral implant placement. Using the NSE grading scale, we found a significant difference in the degree of BAD between the groups, in favor of patients who underwent prepectoral immediate breast reconstruction (0.2 vs. 4, P = 0.000). Inter-and intraobserver agreement was moderate (74%) to strong (88%). Conclusions The incidence and severity of BAD was significantly lower in women reconstructed with a prepectorally placed implant than in those who underwent subpectoral immediate breast reconstruction. All patients reconstructed using the subpectoral technique had some degree of BAD. The inter-and intraobserver agreements were high when using the NSE grading scale, suggesting it is an easy-to-use, reproducible scale for assessing BAD in women who undergo immediate breast reconstruction.

show abstract

Section: Methodsmentioning

confidence: 99%

“…The authors’ direct-to-implant prepectoral technique has been visually illustrated in a recent publication [9,13]. Following mastectomy, the circumference of the breast footprint was marked.…”

Section: Methodsmentioning

confidence: 99%

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Both techniques have been described in detail in an earlier publication. 18 After surgery, the patients followed the same postoperative regime and approximately 3 and 12 months after surgery, each patient was seen in the outpatient clinic by the principal investigator (PI). After surgery and during these clinical visit, information on levels of postoperative pain would be obtained and evaluation of BAD would be made.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Breast Animation Deformity following Pre- and Subpectoral Direct-to-Implant Breast Reconstruction: A Randomized Controlled Trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The incidence of breast animation deformity (BAD) is reported to be substantial after direct-to-implant breast reconstruction with subpectoral implant placement. It has, however, never been examined if BAD can occur following prepectoral implant placement. Our primary aim was to compare the incidence and degree of BAD after direct-to-implant breast reconstruction using either subpectoral or prepectoral implant placement. Secondary aim of this study was to assess and compare the level of pain between sub- and prepectoral reconstructed women. Methods In this randomized controlled trial, patients were allocated to reconstruction by either subpectoral or prepectoral implant placement in accordance with the CONSORT guidelines. The degree of BAD was assessed by the “Nipple, Surrounding skin, Entire breast (NSE)” grading scale 12 months after surgery. The level of postoperative pain was assessed on a numerical pain rating scale. Results We found a significant difference in the degree of BAD favoring patients in the prepectoral group (23.8 vs. 100%, p < 0.0001; mean NSE grading scale score: 0.4 vs. 3.6, p < 0.0001). The subpectoral reconstructed group reported higher levels of pain on the three subsequent days after surgery. No significant difference in pain levels could be found at 3 months postoperatively. Conclusion The incidence and degree of BAD was significantly lower in women reconstructed by prepectoral direct-to-implant breast reconstruction. Unexpectedly, we found mild degrees of BAD in the prepectoral group. When assessing BAD, distortion can be challenging to discern from rippling.

show abstract

“… 11 After implantation, due to the coverage of pectoralis major, its expansion and prolapse will be limited, resulting in the high position of the implant and unnatural submammary folds. 12 …”

Section: Disadvantages Of Subpectoral Breast Reconstruction and The R...mentioning

confidence: 99%

Advances in Prepectoral Breast Reconstruction

Xie¹,

Yan²,

Zhu³

et al. 2023

TCRM

View full text Add to dashboard Cite

Breast reconstruction can be divided into prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR) according to the implant plane. The original prepectoral breast reconstruction was abandoned for a long time due to the frequent and severe complications. Now, advances in materials technology and improved methods of mastectomy have made safe prepectoral breast reconstruction possible. Moreover, a number of studies have gradually demonstrated the advantages of prepectoral breast reconstruction. As prepectoral breast reconstruction becomes more and more attractive, it is time to review the current advances in prepectoral breast reconstruction.

show abstract

Visualized pre- and subpectoral implant placement for immediate breast reconstruction

Cited by 6 publications

References 13 publications

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

Evaluation of Breast Animation Deformity following Pre- and Subpectoral Direct-to-Implant Breast Reconstruction: A Randomized Controlled Trial

Advances in Prepectoral Breast Reconstruction

Contact Info

Product

Resources

About