The Matrix Rib Plating System: improving aesthetic outcomes in microvascular breast reconstruction

Area of Science:

• Plastic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Microvascular breast reconstruction involving internal mammary vessels (IMVs) can lead to chest contour deformity (CCD) due to rib removal.
• Rib plating is explored as a method to mitigate CCD and decrease postoperative pain.

Purpose of the Study:

• To evaluate the efficacy of rib plating in preventing chest contour deformity (CCD) after microvascular breast reconstruction.
• To assess the impact of rib plating on postoperative pain in patients undergoing internal mammary vessel (IMV) reconstruction.

Main Methods:

• A retrospective analysis assessed CCD rates in patients undergoing microvascular breast reconstruction.
• A prospective randomized controlled trial compared rib plating (Synthes Matrix Rib Plating System) versus no plating for IMV reconstruction.
• Postoperative assessments included CCD evaluation and pain scoring.

Main Results:

• Retrospectively, 11.2% of patients had noticeable CCD, with an average BMI of 26.6 kg/m in affected individuals.
• Prospectively, the rib plating group had a 0% rate of visible CCD, compared to 16% in the control group.
• The rib plating group experienced statistically significant reductions in postoperative pain by day 30 at rest.

Conclusions:

• Rib plating effectively prevents chest contour deformity in microvascular breast reconstruction.
• The use of rib plating significantly reduces postoperative pain, improving patient outcomes.
• Rib plating is a safe and beneficial adjunct for improving aesthetics and comfort in IMV-based breast reconstruction.