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Updated: May 22, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Infectious complications associated with the use of acellular dermal matrix in implant-based bilateral breast
Joseph L Hill1, Lesley Wong, Pamela Kemper
1Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
Background:
The use of acellular dermal matrix (ADM) has become a routine practice in implant-based breast reconstruction. Bilateral mastectomy is becoming more popular in cases of unilateral breast cancer. ADM has been associated with an increased incidence of complications.
Methods:
We identified cases of bilateral implant-based breast reconstruction over a 5-year period. Data collection included medical comorbities, details of operative management, and details of postoperative cancer treatment.
Results:
On univariate analysis, the use of ADM (31% vs. 7%, P = 0.018), smoking (37% vs. 13%, P = 0.045), and open wound (55% vs. 13%, P = 0.006) were significantly associated with increased risk of infection. Multivariate analysis revealed open wound as the strongest predictor of infection.
Conclusions:
The use of ADM is associated with an increased risk of infection in bilateral implant-based breast reconstruction. However, it does not appear to be an independent risk factor by itself.
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