Prepectoral Breast Reconstruction without Acellular Dermal Matrix: Have We Come Full Circle?

Abstract

Breast reconstruction is an integral part of breast cancer treatment [...]

Current Global Trends in Prepectoral Breast Reconstruction

“…Moreover, the advantages of two-stage reconstruction include better control over the final position, size, and shape of the implant, as well as a reduced risk of wound healing complications. Additionally, it provides the opportunity for routine fat grafting during the second stage [ 15 , 20 ]. Nevertheless, there are disadvantages associated with two-stage reconstruction, such as the discomfort of filling the expander, potential injury to the expander, and a longer time until final results are achieved.…”

“…Nevertheless, there are disadvantages associated with two-stage reconstruction, such as the discomfort of filling the expander, potential injury to the expander, and a longer time until final results are achieved. On the other hand, single-stage reconstruction has its own disadvantages, including the inability to make fine adjustments to implant size and positioning, as well as increased stress on potentially compromised mastectomy skin flaps [ 20 ]. It is worth noting that one-stage reconstruction is the standard approach in Europe, although there has been an increase in the incidence of one-stage IBBR in the United States in recent years (2016: 10.8% vs. 2019: 17.8%).…”

“…On the other hand, others believe that no definitive conclusions can be drawn at this time and that further surveillance and research are necessary before stating an increased risk of BIA-ALCL. However, it is important to note that there is still a need for larger and higher-quality studies that compare the technique of prepectoral breast reconstruction both with and without the use of ADMs in order to draw any definite conclusions [ 20 ].The latest research on prepectoral breast reconstruction without meshes is illustrated in Table 2 .…”

“…On the other hand, others believe that no definitive conclusions can be drawn at this time and that further surveillance and research are necessary before stating an increased risk of BIA-ALCL. However, it is important to note that there is still a need for larger and higher-quality studies that compare the technique of prepectoral breast reconstruction both with and without the use of ADMs in order to draw any definite conclusions [20].The latest research on prepectoral breast reconstruction without meshes is illustrated in Table 2. PPBR with and without mesh assistance found no difference between groups in hematoma, infection, or explanation rates, whereas capsular contracture and seroma rates were higher in the no-mesh cohort Piers et al [45] 2023 Found no significant differences in outcomes between prepectoral breast reconstruction with and without acellular dermal matrix Chen et al [46] 2023 PPBR with no biosynthetic scaffold had the lowest rates of capsular contracture and may provide the most optimal balance between economic and clinical considerations in implant-based reconstruction…”