Immediate prepectoral implant reconstruction using TiLOOP Bra Pocket results in improved patient satisfaction over dual plane reconstruction

Abstract

Background Implant‐based reconstruction accounts for the majority of breast reconstructive procedures performed in Australia. More recently, immediate prepectoral implant reconstruction using the TiLOOP Bra Pocket has gained popularity. This study compares post‐surgical complications and patient‐reported quality of life outcomes between immediate prepectoral and dual plane implant reconstruction. Methods A retrospective study of 80 consecutive patients who underwent nipple‐sparing mastectomies and immediate implant reconstruction was conducted. Implants were either completely covered with TiLOOP Bra and/or TiLOOP Bra Pocket (pfm medical, Cologne, Germany) and secured in the prepectoral space (prepectoral group) or placed in the subpectoral plane with inferolateral mesh coverage (dual plane group). Data surrounding patient demographics, clinical details and post‐surgical outcomes were compared. Patient‐related quality of life outcomes were assessed with the Breast‐Q questionnaire. Results A total of 80 patients (109 breasts) operated on between June 2016 and December 2018 were included. The prepectoral and dual plane groups comprised of 40 patients each, including 50 and 59 operated breasts, respectively. Post‐operative complications were comparable with 11 (22%) overall complications in the prepectoral group and eight (14%) in the dual plane group (P = 0.313). Implant loss was uncommon with four (8%) cases in the prepectoral group and five (8.5%) in the dual plane group (P = 0.929). Patient‐reported quality of life outcomes were superior after prepectoral reconstruction with patients reporting a significantly higher score in the satisfaction with breasts domain (68.9 versus 57.5; P = 0.036). Conclusion Immediate prepectoral implant reconstruction with the TiLOOP Bra Pocket was associated with improved patient satisfaction and demonstrated no difference in early post‐operative outcomes.

Breakthrough in breast reconstruction in the context of COVID-19: safety and efficiency of endoscopic breast reconstruction at a day surgery center

“…In terms of postoperative esthetics, compared to some reported postoperative satisfaction scores of 57-59 for open reconstruction in patients with a follow up of more than 1 year (19,20), all three groups of patients in the present study had higher satisfaction at 3 months postoperatively (WEP vs WMP vs DSP = 57.38 vs. 57.84 vs. 60.77), and we believe that with gradual recovery and scar fading, postoperative breast satisfaction will further improve. Similarly, the surgical scar with robot-assisted reconstruction was also more often located in the axilla, which was not easily detected, and breast satisfaction was higher than with open reconstruction (21).…”

“…Breast reconstruction surgery is becoming an increasingly popular alternative. In December 2019, coronavirus 2019 (COVID- 19) was discovered and the virus has since become a widespread pandemic, with a high transmission rate and pathogenicity. Studies have shown that controlling staff turnover in public has a significant effect on controlling the spread of COVID-19 (8,9).…”

Prepectoral implant-based breast reconstruction with TiLOOP® Bra Pocket – a single-centre retrospective study

“…To the best of our knowledge, our study showed comparable complication rates with Dieterich and colleagues who published a series with 231 cases using the TiLOOP ® Bra and described an overall complication rate of 29% and implant loss in 8,7% of patients 17 . Ng et al reported on a complication rate of 22% and an 8% rate of implant loss 28 . Our rate of implant loss was 3,2% and is comparable to that seen in other studies.…”

How to convert a submuscular/dual plane reconstruction to a pre‐pectoral pocket implant reconstruction

“…Our preference is to use TiLOOP Bra Pocket™ due to its ease of use and its cost profile. [13][14][15][16][17] However, if the selected new implant, fits snuggly within the neo pocket, no mesh or ADM may be needed, or the use of internal bra sutures may be sufficient.…”

“…If there is discrepancy between the surface area of the implant selected and the overlying skin envelope and or the implant is >400 cc the implant will need the support of a mesh and or controlling with internal lateral bra sutures. Our preference is to use TiLOOP Bra Pocket™ due to its ease of use and its cost profile 13–17 . However, if the selected new implant, fits snuggly within the neo pocket, no mesh or ADM may be needed, or the use of internal bra sutures may be sufficient.…”