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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • The two-stage tissue expander (TE) to implant approach is standard for post-mastectomy breast reconstruction.
  • Previous research established formulas to predict final implant volume based on TE size and fill.
  • The accuracy of these predictive models requires validation.

Purpose of the Study:

  • To evaluate the accuracy of existing formulas for predicting final implant size in two-stage breast reconstruction.
  • To compare predicted versus actual implant sizes in prepectoral and subpectoral breast reconstruction techniques.

Main Methods:

  • Retrospective chart review of patients undergoing two-stage TE to implant breast reconstruction (2021-2024).
  • Collected demographic, oncologic, and reconstructive data.
  • Applied established prediction formulas for prepectoral and subpectoral reconstructions and compared results to actual implant sizes.

Main Results:

  • Included 70 prepectoral (117 breasts) and 39 subpectoral (67 breasts) reconstructions.
  • On average, predicted implant sizes were 23cc smaller than actual sizes (477cc vs. 500cc).
  • Root-mean-square errors were 73.6cc for prepectoral and 54.9cc for subpectoral reconstructions.

Conclusions:

  • Both prepectoral and subpectoral models tended to underpredict final implant size.
  • The models provide an accuracy of 2-4 implant sizes, serving as a useful starting point for surgical planning.
  • Improved prediction accuracy can optimize surgical planning, reduce implant waste, and lower costs in breast reconstruction.