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Revision Rates in Prepectoral Versus Subpectoral Delayed-Immediate Autologous Breast Reconstruction
Ashraf A Patel, Sophie L Cemaj1, Shanique A Martin2
1College of Medicine, University of Nebraska Medical Center, Omaha, NE.
Annals of Plastic Surgery
|April 9, 2021
Summary
Prepectoral breast reconstruction shows significantly lower revision rates compared to subpectoral approaches. This finding suggests prepectoral reconstruction may offer improved long-term outcomes for patients undergoing autologous breast reconstruction.
Area of Science:
- Plastic Surgery
- Oncologic Surgery
- Reconstructive Surgery
Background:
- Prepectoral breast reconstruction is gaining popularity.
- Long-term data on prepectoral reconstruction outcomes are limited.
- Minimizing revision surgeries is crucial for patient care.
Purpose of the Study:
- To compare revision rates between prepectoral and subpectoral delayed-immediate autologous breast reconstruction.
- To identify factors influencing revision necessity in breast reconstruction.
Main Methods:
- Retrospective review of 89 patients (125 reconstructions) from 2009-2018.
- Analysis of demographics, comorbidities, and oncologic history.
- Evaluation of revision rates up to 18 months post-second stage surgery.
Main Results:
- Prepectoral reconstructions had significantly lower revision rates (21.2%) versus subpectoral (47.9%).
- Subpectoral reconstructions showed higher rates of soft tissue rearrangement, fat grafting, and nipple reconstruction.
- Subpectoral expander placement was the sole predictor of requiring revision.
Conclusions:
- Prepectoral breast reconstruction is associated with fewer revisions.
- Subpectoral autologous reconstruction necessitates more frequent soft tissue rearrangement, fat grafting, and nipple reconstruction.
