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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
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Total Muscle Coverage versus AlloDerm Human Dermal Matrix for Implant-Based Breast Reconstruction
J Simon Ivey1, Hamid Abdollahi1, Fernando A Herrera1
1From the Division of Plastic and Reconstructive Surgery, Medical University of South Carolina; and The Institute for Advanced Reconstruction, The Plastic Surgery Center.
Plastic and Reconstructive Surgery
|December 28, 2018
Summary
Acellular dermal matrix in breast reconstruction increases complications and costs compared to total muscle coverage. Total muscle coverage offers quality reconstruction without added risks.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
Background:
- Prosthetic breast reconstruction is a common treatment post-mastectomy.
- Acellular dermal matrices (ADM) are increasingly used in implant-based breast reconstruction.
Purpose of the Study:
- To compare the outcomes of prosthetic breast reconstruction using ADM versus total muscle coverage.
- To analyze complications, fill volumes, expansion requirements, and costs.
Main Methods:
- Retrospective review of 284 patients undergoing 481 implant-based breast reconstructions (August 2002 - December 2013).
- Comparison between patients receiving ADM (AlloDerm) and those with total muscle coverage.
- Analysis of demographics, fill volumes, expansion data, costs, and complications.
Main Results:
- ADM group had significantly higher overall (20.5% vs 8.8%) and major (13.7% vs 5.1%) complication rates.
- ADM group showed increased initial fill volumes but required more expansions (8.1 vs 5.8) and longer expansion time.
- ADM use added an average cost of $2217 per breast.
Conclusions:
- While ADM may allow larger initial fill volumes, it is associated with increased complications and costs.
- Total muscle coverage provides effective breast reconstruction without the elevated risks and expenses of ADM.
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