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Updated: Aug 28, 2025
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Immediate breast reconstruction by prepectoral polyurethane implant: Preliminary results of the prospective study
Benigno Acea Nebril1, Alejandra García Novoa1, Lourdes García Jiménez1
1Unidad de Mama, Servicio de Cirugía General y Aparato Digestivo, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain.
Introduction:
In recent years, mastectomy and reconstruction techniques have evolved towards less aggressive procedures, improving the satisfaction and quality of life of women. For this reason, mastectomy has become a valid option for both women with breast cancer and high-risk women. The objective of this study is to analyze the safety of mastectomy and immediate prepectoral reconstruction with polyurethane implant in women with breast cancer and risk reduction.
Method:
Observational prospective study to evaluate the feasibility and safety of immediate reconstruction using prepectoral polyurethane implant. All women (with breast cancer or high risk for breast cancer) who underwent skin-sparing or skin-and-nipple-sparing mastectomy with immediate reconstruction with a prepectoral polyurethane implant were included. Women with breast sarcomas, disease progression during primary systemic therapy (PST), delayed, autologous or retropectoral reconstruction, and those who did not wish to participate in the study were excluded. Surgical procedures were performed by both senior and junior surgeons. All patients received the corresponding complementary treatments. All adverse events that occurred during follow-up and the risk factors for developing them were analyzed.
Results:
159 reconstructions were performed in 102 women, 80.4% due to breast carcinoma. Fourteen patients developed complications, the most frequent being seroma and wound dehiscence. Eight women required a reoperation (5.0%), seven of them due to implant exposure. Four reconstructions (2.5%) resulted in loss of the implant. Three patients progressed from their oncological process: a local relapse in the mastectomy flap, an axillary progression and a systemic progression.
Conclusions:
Prepectoral reconstruction with a polyurethane implant is a procedure with a low incidence of postoperative complications (8.8%) and implant loss (2.5%). Its use is safe with perioperative cancer treatments (neoadjuvant chemotherapy and radiotherapy).
