PMID- 33791602
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230919
IS  - 2631-4797 (Electronic)
IS  - 2631-4797 (Linking)
VI  - 1
IP  - 1
DP  - 2019 Mar
TI  - Prepectoral Direct-to-Implant Breast Reconstruction: Early Outcomes and Analysis 
      of Postoperative Pain.
PG  - ojz006
LID - 10.1093/asjof/ojz006 [doi]
LID - ojz006
AB  - BACKGROUND: Direct-to-implant (DTI) breast reconstruction provides high-quality 
      aesthetic results in appropriate candidates. Most commonly, implants are placed 
      in the subpectoral space which can lead to pain and breast animation. Surgical 
      and technological advances have allowed for successful prepectoral implant 
      placement which may eliminate these trade-offs. OBJECTIVES: Here we present early 
      outcomes from 153 reconstructions in 94 patients who underwent prepectoral DTI. 
      We sought to determine whether these patients have less postoperative pain and 
      narcotic use than subpectoral implant or expander placement. METHODS: A 
      retrospective review was performed for all prepectoral DTI reconstructions at our 
      institution from 2015 to 2016. Data were collected on postoperative pain and 
      narcotic use while in hospital. RESULTS: The average follow-up time was 8.5 
      months (range, 3-17 months) and the overall complication rate was 27% (n = 41) 
      with the most common complications being skin necrosis (9%, n = 13) and infection 
      (7%, n = 11). No statistically significant difference in complications was found 
      in patients who underwent postmastectomy radiation therapy. Patients who 
      underwent prepectoral DTI reconstruction did not have a statistically significant 
      difference in postoperative pain and narcotic use while in-hospital compared with 
      other techniques. CONCLUSION: Prepectoral DTI reconstruction provides good 
      results with similar complication rates to subpectoral techniques. Prepectoral 
      DTI eliminates the problem of breast animation. Although our series did not reach 
      statistical significance in pain scores or requirement for postoperative 
      narcotics, we believe that it is an important preliminary result and with larger 
      numbers we anticipate a more definitive conclusion.
CI  - (c) 2019 The American Society for Aesthetic Plastic Surgery, Inc.
FAU - Fredman, Rafi
AU  - Fredman R
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Wu, Cindy
AU  - Wu C
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Rapolti, Mihaela
AU  - Rapolti M
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Luckett, Daniel
AU  - Luckett D
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Fine, Jason
AU  - Fine J
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - McGuire, Kandace
AU  - McGuire K
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Gallagher, Kristalyn
AU  - Gallagher K
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
FAU - Roughton, Michelle
AU  - Roughton M
AD  - Division of Plastic and Reconstructive Surgery, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC.
LA  - eng
PT  - Journal Article
DEP - 20190227
PL  - England
TA  - Aesthet Surg J Open Forum
JT  - Aesthetic surgery journal. Open forum
JID - 101771713
PMC - PMC7984832
EDAT- 2019/02/27 00:00
MHDA- 2019/02/27 00:01
PMCR- 2019/02/27
CRDT- 2021/04/01 06:34
PHST- 2021/04/01 06:34 [entrez]
PHST- 2019/02/27 00:00 [pubmed]
PHST- 2019/02/27 00:01 [medline]
PHST- 2019/02/27 00:00 [pmc-release]
AID - ojz006 [pii]
AID - 10.1093/asjof/ojz006 [doi]
PST - epublish
SO  - Aesthet Surg J Open Forum. 2019 Feb 27;1(1):ojz006. doi: 10.1093/asjof/ojz006. 
      eCollection 2019 Mar.