PMID- 34583432
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211009
IS  - 2234-6163 (Print)
IS  - 2234-6171 (Electronic)
IS  - 2234-6163 (Linking)
VI  - 48
IP  - 5
DP  - 2021 Sep
TI  - Direct-to-implant breast reconstruction following nipple-sparing mastectomy: 
      predictive factors of adverse surgical outcomes in Asian patients.
PG  - 483-493
LID - 10.5999/aps.2021.00374 [doi]
AB  - BACKGROUND: Direct-to-implant (DTI) breast reconstruction after nipple-sparing 
      mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable 
      outcomes; however, the use of ADM is associated with a higher risk of 
      complications. We analyzed our experiences of post-NSM DTI without ADM and 
      identified the predictive factors of adverse surgical outcomes. METHODS: Patients 
      who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast 
      reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints 
      were analyzed. RESULTS: There were 100 DTI and 29 TE reconstructions. The TE 
      group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), 
      larger specimens (317.37+/-176.42 g vs. 272.08+/-126.33 g; P=0.047), larger implants 
      (360.84+/-85.19 g vs. 298.83+/-81.13 g; P=0.004) and a higher implant/TE exposure 
      ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds 
      ratio [OR], 5.43; 95% confidence interval [CI], 1.50-19.74; P=0.010) and a larger 
      mastectomy weight (OR, 1.65; 95% CI, 1.08-2.51; P=0.021) were associated with a 
      higher risk of acute complications. Intraoperative radiotherapy for the 
      nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% 
      CI, 1.07-15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% 
      CI, 1.25-24.93; P=0.025). CONCLUSIONS: Immediate DTI breast reconstruction 
      following NSM is feasible in Asian patients with smaller breasts.
FAU - Su, Chun-Lin
AU  - Su CL
AD  - Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive 
      Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
FAU - Yang, Jia-Ruei
AU  - Yang JR
AD  - Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive 
      Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
FAU - Kuo, Wen-Ling
AU  - Kuo WL
AD  - Department of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, 
      Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan, Taiwan.
FAU - Chen, Shin-Cheh
AU  - Chen SC
AD  - Department of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, 
      Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan, Taiwan.
FAU - Cheong, David Chon-Fok
AU  - Cheong DC
AD  - Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive 
      Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan, Taiwan.
FAU - Huang, Jung-Ju
AU  - Huang JJ
AD  - Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive 
      Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan, Taiwan.
AD  - Center for Tissue Engineering, Linkou Chang Gung Memorial Hospital, Taoyuan, 
      Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20210915
PL  - Korea (South)
TA  - Arch Plast Surg
JT  - Archives of plastic surgery
JID - 101577999
PMC - PMC8490122
OTO - NOTNLM
OT  - Breast implant
OT  - Mammaplasty
OT  - Mastectomy
OT  - Treatment outcomes
COIS- Conflict of interest Jung-Ju Huang is an editorial board member of the journal 
      but was not involved in the peer reviewer selection, evaluation, or decision 
      process of this article. No other potential conflicts of interest relevant to 
      this article were reported.
EDAT- 2021/09/29 06:00
MHDA- 2021/09/29 06:01
PMCR- 2021/09/01
CRDT- 2021/09/28 21:31
PHST- 2021/02/20 00:00 [received]
PHST- 2021/07/29 00:00 [accepted]
PHST- 2021/09/28 21:31 [entrez]
PHST- 2021/09/29 06:00 [pubmed]
PHST- 2021/09/29 06:01 [medline]
PHST- 2021/09/01 00:00 [pmc-release]
AID - aps.2021.00374 [pii]
AID - aps-2021-00374 [pii]
AID - 10.5999/aps.2021.00374 [doi]
PST - ppublish
SO  - Arch Plast Surg. 2021 Sep;48(5):483-493. doi: 10.5999/aps.2021.00374. Epub 2021 
      Sep 15.