PMID- 33066236
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 56
IP  - 10
DP  - 2020 Oct 13
TI  - A Comparative Analysis between Subpectoral versus Prepectoral Single Stage 
      Direct-to-Implant Breast Reconstruction.
LID - 10.3390/medicina56100537 [doi]
LID - 537
AB  - Background and objectives: Until now subpectoral breast reconstruction (SBR) has 
      been the predominant form; however, it can present with pectoralis muscle 
      contraction and animation deformity. To avoid these complications, surgeons have 
      begun placing breast implants in the same anatomic space as the breast tissue 
      that was removed. We report a comparative analysis of prepectoral breast 
      reconstruction (PBR) versus subpectoral breast reconstruction to analyze their 
      differences. Materials and Methods: Direct-to-implant (DTI) reconstruction using 
      acellular dermal matrix (ADM) performed from February 2015 to February 2020 were 
      retrospectively reviewed. We then compared the clinical course and postoperative 
      outcomes of the two groups (prepectoral vs. subpectoral) based on the overall 
      incidence of complications, pain scale, and the duration of drainage. Results: A 
      total of 167 patients underwent unilateral DTI, with SBR 114 (68.3%) and PBR 53 
      (31.7%). Patient demographics were similar between the two groups. There was no 
      statistically significant difference in rates of seroma, infection (requiring 
      intravenous antibiotics), hematoma, and skin necrosis. Implant loss rates in the 
      SBR 6.1% (n = 7) and PBR 9.4% (n = 5) were also not statistically significant (p 
      = 0.99). The hemovac duration period was significantly longer in the SBR (14.93 +/- 
      5.57 days) group than in the PBR group (11.09 +/- 4.82 days) (p < 0.01). However, 
      post-operative pain scores are similar between two groups, although it is not 
      clear whether this was due to the effect of postoperative patient-controlled 
      analgesia. Conclusions: A SBR is a commonly used procedure with various 
      advantages, but there are many problems due to damage to the normal pectoralis 
      major muscle. According to the results of our study, the PBR group had a shorter 
      hemovac duration period compared to the SBR group, although there was no 
      significant difference in complication rate. A PBR is a simple and safe technique 
      allowing early discharge without increasing the incidence of long-term 
      complications.
FAU - Kim, Jeong-Hoon
AU  - Kim JH
AUID- ORCID: 0000-0001-5714-6930
AD  - Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong 
      Hospital, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, 
      Yangcheon-gu, Seoul 07985, Korea.
FAU - Hong, Seung Eun
AU  - Hong SE
AUID- ORCID: 0000-0002-6925-6114
AD  - Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong 
      Hospital, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, 
      Yangcheon-gu, Seoul 07985, Korea.
LA  - eng
PT  - Journal Article
DEP - 20201013
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
SB  - IM
MH  - *Breast Implantation/adverse effects
MH  - *Breast Implants/adverse effects
MH  - Humans
MH  - *Mammaplasty/adverse effects
MH  - Mastectomy
MH  - Retrospective Studies
PMC - PMC7602109
OTO - NOTNLM
OT  - acellular dermal matrix
OT  - breast reconstruction
OT  - prepectoral
OT  - subpectoral
COIS- The authors declare no conflict of interest.
EDAT- 2020/10/18 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/10/13
CRDT- 2020/10/17 01:03
PHST- 2020/09/09 00:00 [received]
PHST- 2020/10/06 00:00 [revised]
PHST- 2020/10/09 00:00 [accepted]
PHST- 2020/10/17 01:03 [entrez]
PHST- 2020/10/18 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/10/13 00:00 [pmc-release]
AID - medicina56100537 [pii]
AID - medicina-56-00537 [pii]
AID - 10.3390/medicina56100537 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2020 Oct 13;56(10):537. doi: 10.3390/medicina56100537.