Background Several studies have discussed various methods of prepectoral direct-to-implant (DTI) breast reconstruction using an acellular dermal matrix (ADM) prosthesis to achieve full coverage. However, methods for anterior coverage have rarely been reported. In this study, prepectoral DTI breast reconstruction with complete anterior implant coverage was performed using a square piece of ADM. This study aimed to introduce our prepectoral DTI technique and determine its functional and cosmetic outcomes as well as compare them with those of existing subpectoral DTI techniques. Methods This prospective comparative study focused on 29 patients (35 breasts) and 34 patients (35 breasts) who underwent breast reconstruction via subpectoral implant insertion (control group) and anterior coverage prepectoral implant insertion (anterior coverage group), respectively. Postoperative complications were noted, and breast symmetry was evaluated using the Vectra H2 three-dimensional scanner. The modified Kyungpook National University Hospital Breast-Q (KNUH Breast-Q) scale was used to assess the patient’s subjective satisfaction with the reconstruction and postoperative quality of life. Results No remarkable differences in terms of complications (seroma, skin necrosis, nipple–areola complex necrosis, hematoma, capsular contracture, and infection) were noted in both groups. Compared with controls, considerably better results were observed among those in the anterior coverage group in terms of the mean drain removal period. Furthermore, those in the anterior coverage group showed greater symmetry on three-dimensional scans than the controls; however, this was not statistically significant. Subjective satisfaction and postoperative quality of life measured using the KNUH Breast-Q scale were not significantly different between both groups. Conclusions Considering its stability, faster recovery time, and cosmetic benefit, prepectoral breast reconstruction with anterior implant coverage using a single, large ADM is a good choice to perform breast reconstruction with implant insertion in patients who have undergone mastectomy. Level of evidence: II.
Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery. - Abstract - Europe PMC
Two ADM sheets are sutured together side-to-side and laid over top of
Illustration of submuscular breast implant suspended by the AlloDerm
Anterior coverage of the implant with ADM. Meshed ADM provided complete
A Guide to Prepectoral Breast Reconstruction: A New Dimension to Implant-based Breast Reconstruction - ScienceDirect
One-Step Breast Reconstruction with Implants
PDF) Prepectoral Site Conversion for Animation Deformity
Most common meshes used for breast reconstruction.
Prepectoral Implant Based Reconstruction Melbourne, VIC
Medicina, Free Full-Text
Meshes and Implants in Prepectoral Breast Reconstruction: Selecting the Right One
Immediate Breast Reconstruction in Skin-Reducing Mastectomy with Prepectoral Polyuretane (Pu) Implant Covered with an Autologous Dermo-Adipose Flap
