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. 2022 Apr 6;49(2):158-165.
doi: 10.1055/s-0042-1744404. eCollection 2022 Mar.

Comparison of Outcomes in Immediate Implant-Based Breast Reconstruction: Acellular Dermal Matrix versus Inferior Dermal Flap

Luís Mata Ribeiro  1 , Rita P Meireles  2 , Irís M Brito  2 , Patrícia M Costa  1 , Marco A Rebelo  3 , Rui F Barbosa  3 , Miguel P Choupina  3 , Carlos J Pinho  3 , Matilde P Ribeiro  3
Affiliations

Comparison of Outcomes in Immediate Implant-Based Breast Reconstruction: Acellular Dermal Matrix versus Inferior Dermal Flap

Luís Mata Ribeiro et al. Arch Plast Surg. .

Abstract

Background Implant-based breast reconstruction has evolved tremendously in the last decades, mainly due to the development of new products and techniques that make the procedure safer and more reliable. The purpose of this study was to compare the outcomes in immediate one-stage breast reconstruction between acellular dermal matrix (ADM) and inferior dermal flap (IDF). Methods We conducted a retrospective comparative study of patients submitted to immediate breast reconstructions with an anatomical implant and ADM or IDF in a single center between 2016 and 2018. Outcomes evaluated included major complications, early complications, reinterventions, readmissions, and reconstruction failure. Simple descriptive statistics and univariate analysis were performed. Results A total of 118 breast reconstructions (85 patients) were included in the analysis. Patients in the IDF group had a higher body mass index (median = 27.0) than patients in the ADM group (median = 24). There were no statistically significant differences among both groups regarding immediate major complication, early complications, readmissions, and reinterventions. Conclusion There are no significant differences in complications between the ADM and IDF approach to immediate implant breast reconstruction. In patients with higher body mass index and large, ptotic breasts, we recommend an immediate implant reconstruction with IDF.

Keywords: acellular dermis; breast implants; mammaplasty; mastectomy; retrospective studies.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Illustrative images depicting acellular dermal matrix  + implant breast reconstruction. ( A ) Profile view. ( B ) Frontal view.
Fig. 2
Fig. 2
Pectoralis major muscle elevation.
Fig. 3
Fig. 3
Acellular dermal matrix suture to pectoralis major muscle.
Fig. 4
Fig. 4
Implant insertion below pectoralis major and acellular dermal matrix.
Fig. 5
Fig. 5
Acellular dermal matrix anchoring to inframammary fold.
Fig. 6
Fig. 6
Acellular dermal matrix covering lower pole of the implant.
Fig. 7
Fig. 7
Illustrative images depicting inferior dermal flap  + implant breast reconstruction. ( A ) Wise-pattern markings (“A,” “B,” and “C” represent the vertices) and area to be deepithelialized; gray area will be removed. ( B ) After mastectomy, showing pectoralis major and IDF. ( C ) After implant placement and initial closing sutures between pectoralis major and IDF. ( D ) Final aspect, the initial points “B” and “C” joint together.
Fig. 8
Fig. 8
Initial Wise-pattern markings and deepithelization.
Fig. 9
Fig. 9
Pectoralis major muscle dissected and pocket created; # signals PM muscle; * signals inferior dermal flap.
Fig. 10
Fig. 10
Implant insertion and initial closing sutures.
Fig. 11
Fig. 11
Final intraoperative result.
See this image and copyright information in PMC

References

    1. Nair A, Jaleel S, Abbott N, Buxton P, Matey P. Skin-reducing mastectomy with immediate implant reconstruction as an indispensable tool in the provision of oncoplastic breast services. Ann Surg Oncol. 2010;17(09):2480–2485. - PubMed
    1. Ellabban M A, Nawar A, Milad H, Ellabban M G. Single-stage immediate breast reconstruction using anatomical silicone-based implant and the hammock technique of dermal-muscle flap in large and ptotic breasts: a multicenter study. World J Surg. 2020;44(06):1925–1931. - PubMed
    1. Tasoulis M K, Teoh V, Khan A, Montgomery C, Mohammed K, Gui G.Acellular dermal matrices as an adjunct to implant breast reconstruction: analysis of outcomes and complications Eur J Surg Oncol 202046(4 Pt A):511–515. - PubMed
    1. Krishnan N M, Fischer J P, Basta M N, Nahabedian M Y. Is single-stage prosthetic reconstruction cost effective? A cost-utility analysis for the use of direct-to-implant breast reconstruction relative to expander-implant reconstruction in postmastectomy patients. Plast Reconstr Surg. 2016;138(03):537–547. - PubMed
    1. Remington A C, Gurtner G C, Wan D C, Nguyen D, Momeni A. Identifying risk factors for postoperative major complications in staged implant-based breast reconstruction with AlloDerm. Breast J. 2019;25(04):597–603. - PubMed