Advances in Prepectoral Breast Reconstruction

Xie, Jiaheng; Yan, Wei; Zhu, Zhechen; Wang, Ming; Shi, Jingping

doi:10.2147/tcrm.s404799

Cited by 6 publications

(3 citation statements)

References 70 publications

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“…Over recent years, prepectoral reconstruction regained a new life, and it represents the first option in many breast units for selected patients. [40][41][42] The main limitation is the cost of ADMs, but the advantages are clear, and the results obtained using our new standardized technique provide excellent evidence to consider.…”

Section: Standard New Totalmentioning

confidence: 90%

Prepectoral Breast Reconstruction with Prosthesis and Acellular Dermal Matrix: A New Technique of ADM Implantation and Fixation

Tettamanzi,

Arrica,

Ziani

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Direct-to-implant (DTI) immediate breast reconstruction has proven to be an oncologically safe technique and linked to better overall results. The introduction of new surgical techniques has prompted us to develop an acellular dermal matrix fixation technique that reduces the rate of complications and implant loss. Methods: We retrospectively analyzed data from patients who underwent DTI prepectoral breast reconstruction with two different techniques of acellular dermal matrix fixation to the chest wall. Descriptive statistics were reported using frequencies and percentages for categorical variables, and means and SDs for continuous variables. Pearson chi-square test was used to compare differences in categorical variables. Univariable and multivariable logistic regression models were fitted to investigate the predictors of complications. Results: From October 2019 to March 2023, 90 DTI breast reconstructions were performed, 43 using the standard technique and 47 using the new technique. The new technique demonstrated a significant reduction of major complications (P = 0.010), namely seroma (13.9% versus 2.3%), skin necrosis (9.3% versus 2.3%), implant loss (7% versus 0%), wound dehiscence (9.3% versus 0%), and infection (4.7% versus 0%). Compared with the standard technique, the new one reduced the risk of complications by 76% (OR 0.24; 95% confidence interval 0.09–0.68; P = 0.007) and 73% (aOR 0.27; 95% confidence interval 0.08–0.92; P = 0.037), at univariable and multivariable regression models. No other significant predictor of complications was identified. Conclusions: The procedure performed with the proposed modality proved to be advantageous. Careful fixation of the prosthetic implant and the placement of two drains, were the keys to a drastic reduction in complications.

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Section: Standard New Totalmentioning

confidence: 90%

Prepectoral Breast Reconstruction with Prosthesis and Acellular Dermal Matrix: A New Technique of ADM Implantation and Fixation

Tettamanzi,

Arrica,

Ziani

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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“…In the United Kingdom, fifty-five thousand women are diagnosed with breast cancer on an annual basis, and it has been found that 40% of these women require a mastectomy [ 1 ]. The removal of a breast can have a profound impact on the overall quality of life for these women, leading to psychological inferiority and a decrease in social integration [ 1 , 2 ]. As part of the comprehensive treatment for breast cancer, breast reconstruction plays a pivotal role as it not only enhances the aesthetic appearance but also restores the natural contours of the breast [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The predominant approach utilized in the United Kingdom for immediate reconstructions after mastectomy is an implant-based reconstruction (IBBR), accounting for nearly 70% of all cases [ 4 ]. When it comes to the placement of the implant, there are two categories to consider: prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR) [ 2 ]. Prepectoral breast reconstruction was initially introduced in the early 1960s and showed great promise in its early results [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Current Global Trends in Prepectoral Breast Reconstruction

Taj,

Chandavarkar,

Vidya

2024

Medicina

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Implant-based breast reconstruction (IBBR) is the most frequently performed procedure for breast reconstruction following mastectomy, which involves the surgical placement of breast implants. The approach to breast reconstruction can be divided into two main categories, namely prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR), based on the implant plan and placement technique. In recent years, there has been a significant surge in the popularity of prepectoral implant-based breast reconstruction, where the implants are positioned above the chest muscle, as opposed to beneath it in the subpectoral approach. However, despite this growing preference, there is a lack of comprehensive data regarding the national trends in the utilization of this technique, thus necessitating further investigation. This narrative review aims to ascertain the current global patterns linked to prepectoral breast reconstruction and elucidate the considerations surrounding patient and implant selection, reconstructive techniques, the utilization of meshes in prepectoral reconstruction, the ensuing outcomes and complications, the ramifications of radiotherapy, and the potential advantages of integrating fat infiltration into the implementation of this technique in breast reconstruction with a focus on published papers in last five years. Conclusion: Prepectoral breast reconstruction has emerged as an appropriate surgical option for individuals seeking breast reconstruction. This development can be attributed to the recent progress made in implant technology, which has significantly enhanced the outcomes of this procedure. Additionally, advancements in mastectomy techniques, autologous fat grafting, and the use of acellular dermal matrices (ADMs) have also played a vital role in improving the aesthetic results of prepectoral breast reconstruction. As a result, the significance and effectiveness of this technique in the field of breast reconstruction have been firmly established, making it an essential component of the overall armamentarium available to plastic surgeons for breast reconstruction purposes.

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