A systematic review and meta-analysis on the prepectoral and partial subpectoral immediate single-stage Implant-Based...

Acellular dermal matrices (ADMs) have made immediate single-stage prepectoral breast reconstruction (PBR) feasible and have promoted the application and development of partial subpectoral breast reconstruction (SBR). The type of mesh is regarded as a key factor influencing the safety of breast reconstruction. The optimal choice between prepectoral and partial subpectoral approaches for ADM-assisted immediate single-stage prosthetic breast reconstruction remains controversial. This study aimed to compare the safety profiles of these two surgical techniques.

A systematic literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library. All included patients underwent immediate single-stage implant-based breast reconstruction using ADM. Patient characteristics and postoperative complications were collected and summarized. Data analysis was performed using Cochrane RevMan and IBM SPSS software.

The meta-analysis incorporated 1,557 reconstructed breasts from eight eligible observational studies. Overall, PBR significantly reduced the total complication rate following immediate single-stage breast reconstruction compared with SBR. Additionally, PBR was associated with significantly lower rates of postoperative hematoma and skin-nipple necrosis compared with SBR.

The meta-analysis demonstrated that PBR was associated with lower safety risks for ADM-assisted immediate single-stage implant-based breast reconstruction.