Related Experiment Video
Updated: Jun 2, 2025
13:35
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
2.4K
A Comparative Study of One-Stage Pre-pectoral Implant Breast Reconstruction With and Without Mesh
Hamed Hajiesmaeili1, Shahram Shirazi2, Kapil Agrawal3
1Breast Surgery, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR.
Cureus
|January 14, 2025
Summary
Pre-pectoral breast reconstruction without acellular dermal matrix (ADM) is a cost-effective option. Early outcomes are comparable to reconstructions using ADM, with no significant differences in complications like infection or implant loss.
Area of Science:
- Plastic Surgery
- Oncologic Reconstruction
- Surgical Outcomes Research
Background:
- Pre-pectoral implant-based breast reconstruction offers advantages over sub-pectoral techniques, including reduced pain and faster recovery.
- Acellular dermal matrix (ADM) is utilized in pre-pectoral reconstruction for implant support and improved aesthetics, but it increases costs.
- The necessity and impact of ADM in one-stage pre-pectoral breast reconstruction require further investigation.
Purpose of the Study:
- To compare the early postoperative outcomes of one-stage pre-pectoral implant-based breast reconstruction performed with and without acellular dermal matrix (ADM).
- To evaluate the cost-effectiveness of using ADM in this reconstructive technique.
Main Methods:
- Retrospective cohort analysis of 101 patients undergoing one-stage pre-pectoral breast reconstruction between May 2019 and July 2023.
- Patients were divided into two groups: those who received ADM (n=52) and those who did not (n=49).
- Demographics, implant size, and postoperative complications (infection, seroma, implant loss) were compared using chi-square tests.
Main Results:
- No statistically significant differences were observed in the rates of infection, seroma requiring aspiration, or implant loss between the ADM and no-ADM groups.
- Patients receiving ADM were younger (median 50 vs. 56 years) and had larger implants (median 430 vs. 330 cc).
- A statistically higher proportion of patients in the ADM group required postoperative radiotherapy (p=0.049).
Conclusions:
- One-stage pre-pectoral breast reconstruction without ADM is a cost-effective approach with comparable early postoperative outcomes to reconstructions utilizing ADM.
- The study demonstrates satisfactory early results for pre-pectoral reconstruction without ADM, challenging the routine use of this adjunct.
- Further research is recommended to assess longer-term and patient-reported outcomes to fully elucidate the benefits and drawbacks of ADM in this setting.
