Direct-to-Implant Extracellular Matrix Hammock-based Breast Reconstruction; Prepectoral or Subpectoral?

Area of Science:

• Oncology
• Plastic Surgery
• Reconstructive Surgery

Background:

• Skin-sparing mastectomy with immediate implant-based breast reconstruction is common.
• Subpectoral implant placement can lead to breast animation deformity (BAD) and prolonged recovery.
• Prepectoral implant placement may mitigate BAD but presents challenges with thinner skin coverage.

Purpose of the Study:

• To compare the incidence and severity of BAD between prepectoral and subpectoral implant placement in direct-to-implant breast reconstruction.
• To evaluate secondary outcomes including shoulder/arm function, quality of life, aesthetics, and complications.

Main Methods:

• Prospective, multi-center, randomized controlled trial.
• 70 patients undergoing direct-to-implant breast reconstruction.
• Comparison of prepectoral versus subpectoral implant placement.
• Follow-up at 3 months and 1 year post-surgery.

Main Results:

• Incidence and degree of breast animation deformity (BAD) will be assessed.
• Shoulder and arm function, quality of life, and aesthetic outcomes will be compared.
• Complications, length of stay, and need for surgical corrections will be recorded.

Conclusions:

• This is the first randomized controlled trial comparing subpectoral and prepectoral implant placement for direct-to-implant breast reconstruction.
• Results will enhance understanding of immediate breast reconstruction outcomes.
• Findings aim to improve preoperative planning and patient counseling.