Incidence of capsular contracture on irradiated acellular dermal matrices (ADMs)-assisted prepectoral breast reconstructions

Saibene, Tania; Cecconi, Claudia; Toffanin, Maria Cristina; Cagol, Matteo; Ferrucci, Massimo; Grigoletto, R; Michieletto, Silvia

doi:10.21037/abs-21-141

Cited by 3 publications

(17 citation statements)

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“…Having proved to be a safe scaffold producing stable results over time (53), several research groups have studied its clinical outcomes even outside the stringent PPBR guidelines on RT. In other words, a slight increase in the incidence of capsular contracture was found, but without any worsening in the overall and final reconstructive outcome (27,51,53). According to the literature, prepectoral irradiation would have more lenient side effects than submuscular irradiation (23, 27,95,132), which entails the risk of patients incurring muscle fibrosis with consequent muscle shortening and tightening, elevating any underlying device as the implant pocket starts to contract (27).…”

Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 98%

“…In other words, a slight increase in the incidence of capsular contracture was found, but without any worsening in the overall and final reconstructive outcome (27,51,53). According to the literature, prepectoral irradiation would have more lenient side effects than submuscular irradiation (23, 27,95,132), which entails the risk of patients incurring muscle fibrosis with consequent muscle shortening and tightening, elevating any underlying device as the implant pocket starts to contract (27). Sigalove and Saibene and colleagues firmly argue that the reconstruction outcome is strongly influenced by the reconstructive plan and by the material used, when RT is administered.…”

Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 98%

“…Over time, this has led to the collection of many clinical insights even on patients not strictly suitable for PPBR, allowing a study of reconstructive material behavior in this specific setting (53). Braxon® is one of the few breast-reconstructive devices for which clinical outcomes in conjunction with RT are available (27). At the beginning of 2020, Polotto et al published the results of a retrospective analysis on Braxon®-assisted PPBRs in the setting of PMRT.…”

Section: Radiotherapymentioning

confidence: 99%

“…Sigalove and Saibene and colleagues firmly argue that the reconstruction outcome is strongly influenced by the reconstructive plan and by the material used, when RT is administered. Based on the proven ADM regenerative potential and on early published evidence, a possible protective role for ADMs from the effects of RT is, therefore, hypothesized (27,95). The premises seem promising, but similar hypotheses and clinical results must still be confirmed with further studies, in order to ensure a safe clinical practice.…”

Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 99%

“…Starting with Berna et al, more than 50 scientific publications give evidence of the clinical efficacy of this method, making Braxon ® one of the most studied breast reconstruction devices in the world. This leap toward breast-specific ADMs defines a third generation of matrices especially tailored to the characteristics of the implantation site, and optimized for prepectoral breast reconstruction (PPBR), giving this technique the possibility to become, in the future, the gold standard in IBR ( 25 – 27 ). As a matter of fact, a large number of studies have demonstrated the feasibility, safety, and advantages of this approach, which today represents the easiest way to reconstruct the breast with an implant, as it replaces the missing volume exactly from where it was removed ( 26 , 28 ).…”

Section: Introductionmentioning

confidence: 99%

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Braxon®-assisted prepectoral breast reconstruction: A decade later

et al. 2022

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We are sitting on the cusp of the bioengineered breast era, in which implant-based breast reconstruction is seeing a growing trend and biotechnology research progressively empowers clinical practice. As never before, the choice of biomaterials has acquired great importance for achieving reconstructive outcomes, and the increase in the use of acellular dermal matrices (ADMs) in the field of senology tells us a story of profound upheaval and progress. With the advent of prepectoral breast reconstruction (PPBR), plenty of devices have been proposed to wrap the silicone prosthesis, either completely or partially. However, this has caused a great deal of confusion and dissent with regard to the adoption of feasible reconstructive strategies as well as the original scientific rationale underlying the prepectoral approach. Braxon® is the very first device that made prepectoral implant positioning possible, wrapping around the prosthesis and exerting the proven ADM regenerative potential at the implant–tissue interface, taking advantage of the body's physiological healing mechanisms. To date, the Braxon® method is among the most studied and practiced worldwide, and more than 50 publications confirm the superior performance of the device in the most varied clinical scenarios. However, a comprehensive record of the working of this pioneering device is still missing. Therefore, our aim with this review is to lay a structured knowledge of surgery with BRAXON® and to provide a decision-making tool in the field of PPBR through a complete understanding on the very first device for prepectoral, one decade after its introduction.

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Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 98%

Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 98%

Section: Radiotherapymentioning

confidence: 99%

Section: Why Then Do We Perform Prepectoral Reconstruction Surgeries ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Braxon®-assisted prepectoral breast reconstruction: A decade later

et al. 2022

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Immediate post-mastectomy prepectoral breast reconstruction with animal derived acellular dermal matrices: A systematic review

Tellarini,

Garutti,

Corno

et al. 2023

Journal of Plastic, Reconstructive & Aesthetic Surgery

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A Two-Year Retrospective Analysis of the Clinical Outcomes of Immediate Submuscular Breast Reconstructions With Native® Acellular Dermal Matrix

Martins,

Barbosa,

Guerreiro

et al. 2023

Cureus

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Background: Implant-based submuscular breast reconstruction (SBR) can be performed with the aid of acellular dermal matrices (ADM) for implant coverage on their inferolateral pole, aiming at providing a biological interface for hiding the implant and therefore reducing the risk of complications. The purpose of this study is to assess the long-term post-operative outcomes obtained using the SBR-specific Native® ADM (DECO med s.r.l., Marcon, Venice, Italy). Methods: All cases of Native®-assisted immediate SBR performed at our institution between October 2016 and March 2020 were retrospectively analysed. Demographic and surgical data were collected, and post-operative outcomes, including minor and major complications, were evaluated. Particular attention was paid to complications emerging before and after patient discharge. Dependence analyses were performed to uncover statistically significant relationships between risk factors and reconstructive outcomes. Results: Data on 100 patients were collected, for a total of 128 breasts. The mean age of the cohort was 49.5 years, the mean BMI was 23.4 kg/m2, and the mean follow-up was 24 months. Out of this, 14.1% of patients received pre-operative radiotherapy, while 16.4% underwent post-mastectomy radiotherapy. Breasts appeared to develop short-term minor complications more likely during hospitalisation (11.7% vs. 7.8%), while short-term major complications occurred more often after discharge (7.8% vs. 15.6%). The most frequent long-term complications were capsular contracture and contour defects (both 9.4%). Risk factors that showed a statistically significant relationship with complications were pre- and post-mastectomy radiotherapy and post-operative chemotherapy. Conclusions: The retrospective analysis showed results in line with clinical outcomes reported in the literature for the same reconstructive technique. The use of Native® ADM in SBR is safe and effective in the long term.

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Incidence of capsular contracture on irradiated acellular dermal matrices (ADMs)-assisted prepectoral breast reconstructions

Cited by 3 publications

References 0 publications

Braxon®-assisted prepectoral breast reconstruction: A decade later

Braxon®-assisted prepectoral breast reconstruction: A decade later

Immediate post-mastectomy prepectoral breast reconstruction with animal derived acellular dermal matrices: A systematic review

A Two-Year Retrospective Analysis of the Clinical Outcomes of Immediate Submuscular Breast Reconstructions With Native® Acellular Dermal Matrix

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