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Updated: May 15, 2026
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Cost minimisation analysis of using acellular dermal matrix (Strattice™) for breast reconstruction compared with
R K Johnson1, C K Wright, A Gandhi
1Nightingale Centre and Genesis Breast Cancer Prevention Centre, University Hospital South Manchester, Wythenshawe, M23 9LT Manchester, UK. richard.johnson@uhsm.nhs.uk
Summary
The one-stage acellular dermal matrix (Strattice) breast reconstruction is more cost-effective than two-stage tissue expander (TE) or latissimus dorsi (LD) flap procedures for unilateral cases. This financial advantage highlights Strattice
Area of Science:
- Plastic Surgery
- Health Economics
Background:
- Immediate breast reconstruction is a critical component of oncologic treatment.
- Acceullar dermal matrix (Strattice) offers a novel one-stage approach compared to traditional two-stage tissue expander (TE) or latissimus dorsi (LD) flap reconstructions.
Purpose of the Study:
- To conduct a cost analysis comparing the one-stage Strattice technique with standard two-stage TE/implant and LD flap reconstructions.
- To evaluate the financial implications for the National Health Service (NHS) in the UK.
Main Methods:
- A cost analysis using UK 2011/12 NHS tariffs.
- Clinical data from 24 patients undergoing one-stage Strattice reconstruction were collected.
- Comparison with historical control groups matched for key variables.
Main Results:
- Unilateral Strattice reconstruction cost £3685, compared to £4985 for unilateral TE/implant and £6321 for unilateral LD flap.
- Bilateral Strattice reconstruction cost £6771, compared to £5478 for bilateral TE/implant.
- Strattice demonstrated a clear cost advantage in unilateral breast reconstruction.
Conclusions:
- Acceullar dermal matrix (Strattice) offers a significant financial advantage for unilateral breast reconstruction.
- The findings are relevant internationally due to similar reimbursement systems based on reported hospital costs.