Regional and National Trends Over 20 Years in One-Stage vs Two-staged Implant Based Breast Reconstruction

Abstract

OBJECTIVES: It is well documented (Cunnigham et al, 2002) that orthognathic surgery improves quality of life in terms of enhanced oral function, facial aesthetics and wellbeing.Prior to a large multi-centre study performed by Garg et al, 2009 there are no studies that look at operating time and length of in-patient stay for orthognathic procedures.We aimed to compare operative time and length of inpatient stay for in our diverse group of patients against the published data, in addition to assessing readmission/reoperation rate at 7 and 30 days post-operatively. METHODS:Our busy central London Orthognathic Unit treats a diverse selection of patients with complex facial deformity. We devised a 3-year retrospective analysis of 130 patients who underwent (1) routine primary orthognathic surgery; (2) revisional orthognathic surgery and (3) primary orthognathic surgery in Syndromic patientsat University College London Hospital.We collected data from hospital records of all patients who underwent 4 orthognathic procedures; (1) Bimaxillary Osteotomy; (2) Le Fort 1 Osteotomy; (3) Mandible BSSO and (4) Genioplasty. RESULTS:Our data highlights that our operating times and length of in-patient stay for the 3 most common and conventional orthognathic procedures performed in the United Kingdom, is significantly lower compared to the published data to date. CONCLUSIONS:We believe that the results achieved within our Unit reflect a combination of the unique orthognathic protocol, operative technique, and multidisciplinary management employed for all of our patients.There is no doubt that the robust documentation of such data will be an invaluable resource for professional revalidation, clinical governance, healthcare commissioning and safeguarding surgical practice.

Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

“…7,8 Of those patients who elect treatment with mastectomy, approximately 70% will subsequently undergo implant-based reconstruction. 9 Given these trends, there has been a 39% increase in breast reconstruction procedural volume since 2000, with 109,256 breast reconstruction procedures occurring in 2016 alone. 5,10 Of these, tissue expander followed by implant reconstruction accounted for 79,019 cases, and 58,310 breast reconstructive procedures utilized ADMs.…”

Acellular Dermal Matrix in Prosthetic Breast Reconstructive Surgery with Prepectoral Technique: A Literature Review

“…Advances in early diagnosis, identification of patients at high risk of developing cancer in familial-hereditary status, oncological and breast studies are progressively extending patients overall survival (OS) and disease-free survival (DFS) highlighting the importance of quality of life concept [3]. In fact, approximately 35-40% of women diagnosed with breast cancer undergo a surgical mastectomy and about 75% of them receive breast reconstruction (BR) after mastectomy [4,5].…”

Immediate Breast Reconstruction in The Netherlands and the United States: A Proof-of-Concept to Internationally Compare Quality of Care Using Cancer Registry Data

“…[26][27][28][29][30][31][32][33][34][35] However, it is unknown whether this recommendation is being followed across the globe, as the majority of studies report large variability in breast reconstruction rates both within and across countries. 2,[36][37][38][39][40][41][42][43][44][45][46][47][48] We present the first international comparison of immediate breast reconstruction treatment patterns between the national Dutch breast cancer database National Breast Cancer Organization The Netherlands (NABON) Breast Cancer Audit and the most widely used, population-based tumor registry database of the United States, Surveillance, Epidemiology, and End Results. The aims of this study were twofold: (1) to evaluate the comparability of the two databases and, as an example, to show the importance of the possibility of comparisons; and (2) to evaluate the differences in immediate breast reconstruction rates between both countries.…”