PMID- 36944866 OWN - NLM STAT- MEDLINE DCOM- 20230802 LR - 20230803 IS - 1432-5241 (Electronic) IS - 0364-216X (Linking) VI - 47 IP - 4 DP - 2023 Aug TI - Prepectoral Versus Subpectoral Direct-to-Implant Breast Reconstruction: Evaluation of Patient's Quality of Life and Satisfaction with BREAST-Q. PG - 1291-1299 LID - 10.1007/s00266-023-03316-z [doi] AB - BACKGROUND: Over the years, plastic surgery has acquired a central role in the integrated treatment of breast cancer. Direct-to-implant (DTI) reconstruction using the prepectoral approach has emerged as an alternative to reconstruction using the subpectoral technique to overcome the complications arising from this type of surgery resulting as a consequence of muscle elevation. The satisfaction and quality of life of patients undergoing DTI breast reconstruction were evaluated using the BREAST-Q questionnaire, comparing the prepectoral and the subpectoral technique. METHODS: A single-center cross-sectional study on patients who underwent mastectomy and DTI breast reconstruction at our institution between 2013 and 2021 was conducted. Eighty-one patients were included and mainly divided into two groups based on the surgical procedure: 52 patients undergoing a subpectoral breast reconstruction approach and 29 patients receiving a prepectoral breast reconstruction. In order to assess the quality of life, the postoperative BREAST-Q module was administered electronically to the enrolled patients. RESULTS: Higher scores in BREAST-Q domains were recorded from patients who underwent mastectomy and breast reconstruction with prepectoral technique: psychosocial well-being (P<0.0085), sexual well-being (P<0.0120), physical well-being: lymphoedema (P<0.0001) and satisfaction with information received (P<0.0045). There were further statistically significant differences between the two groups with regard to postoperative complications (p<0.0465) and the need for reoperation (p<0.0275). CONCLUSIONS: Patients who underwent DTI breast reconstruction with prepectoral technique were more satisfied in terms of psychosocial, sexual and also physical well-being. These patients also had statistically lower complications and reoperations compared to patients who received breast reconstruction with the subpectoral technique. LEVEL OF EVIDENCE IV: This journal requires that authors 38 assign a level of evidence to each article. For a full 39 description of these Evidence-Based Medicine ratings, 40 please refer to the Table of Contents or the online 41 Instructions to Authors www.springer.com/00266 . CI - (c) 2023. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery. FAU - Cogliandro, Annalisa AU - Cogliandro A AUID- ORCID: 0000-0001-9497-6757 AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. a.cogliandro@policlinicocampus.it. FAU - Salzillo, Rosa AU - Salzillo R AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - De Bernardis, Riccardo AU - De Bernardis R AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - Loria, Francesco Saverio AU - Loria FS AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - Petrucci, Valeria AU - Petrucci V AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - Barone, Mauro AU - Barone M AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. AD - Research group "To be and to appear: Objective indication to Plastic Surgery" of Campus Bio-Medico University in Rome, Rome, Italy. FAU - Tenna, Stefania AU - Tenna S AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - Cagli, Barbara AU - Cagli B AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. FAU - Persichetti, Paolo AU - Persichetti P AD - Fondazione Policlinico Universitario, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy. AD - Research group "To be and to appear: Objective indication to Plastic Surgery" of Campus Bio-Medico University in Rome, Rome, Italy. LA - eng PT - Journal Article DEP - 20230321 PL - United States TA - Aesthetic Plast Surg JT - Aesthetic plastic surgery JID - 7701756 SB - IM CIN - Aesthetic Plast Surg. 2023 Aug;47(4):1300-1302. PMID: 37261493 MH - Humans MH - Female MH - Mastectomy/methods MH - *Breast Implantation/methods MH - *Breast Neoplasms/surgery/etiology MH - *Breast Implants MH - Quality of Life MH - Cross-Sectional Studies MH - Patient Satisfaction MH - *Mammaplasty/methods MH - Personal Satisfaction MH - Retrospective Studies OTO - NOTNLM OT - BREAST-Q OT - Breast reconstruction OT - DTI OT - Implant OT - Mastectomy OT - PROMs OT - Plastic surgery OT - Prepectoral OT - Subpectoral EDAT- 2023/03/23 06:00 MHDA- 2023/08/02 06:42 CRDT- 2023/03/22 00:29 PHST- 2022/12/22 00:00 [received] PHST- 2023/02/26 00:00 [accepted] PHST- 2023/08/02 06:42 [medline] PHST- 2023/03/23 06:00 [pubmed] PHST- 2023/03/22 00:29 [entrez] AID - 10.1007/s00266-023-03316-z [pii] AID - 10.1007/s00266-023-03316-z [doi] PST - ppublish SO - Aesthetic Plast Surg. 2023 Aug;47(4):1291-1299. doi: 10.1007/s00266-023-03316-z. Epub 2023 Mar 21.