scholarly journals One-Stage Immediate Breast Reconstruction: A Concise Review

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Nicolò Bertozzi ◽  
Marianna Pesce ◽  
Pierluigi Santi ◽  
Edoardo Raposio
Keyword(s):  
Breast Reconstruction ◽  
Acellular Dermal Matrix ◽  
Synthetic Mesh ◽  
Immediate Breast Reconstruction ◽  
Fat Grafting ◽  
Dermal Matrix ◽  
One Stage ◽  
Care Outcomes ◽  
Ptotic Breasts ◽  
Staged Reconstruction

Background. One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness.Material and Methods. We reviewed the available literature on one-stage direct-to-implant IBR, with or without acellular dermal matrix (ADM), synthetic mesh, or autologous fat grafting. We analyzed the indications, preoperative work-up, surgical technique, postoperative care, outcomes, and complications.Results. IBR is indicated for small-to-medium nonptotic breasts and contraindicated in patients who require or have undergone radiotherapy, due to unacceptably high complications rates. Only patients with thick, well-vascularized mastectomy flaps are IBR candidates. Expandable implants should be used for ptotic breasts, while anatomical shaped implants should be used to reconstruct small-to-medium nonptotic breasts. ADMs can be used to cover the implant during IBR and avoid muscle elevation, thereby minimizing postoperative pain. Flap necrosis, reoperation, and implant loss are more common with IBR than conventional two-staged reconstruction, but IBR has advantages such as lack of secondary surgery, faster recovery, and better quality of life.Conclusions. IBR has good outcomes and patient-satisfaction rates. With ADM use, a shift from conventional reconstruction to IBR has occurred. Drawbacks of IBR can be overcome by careful patient selection.

scholarly journals One stage implant-based reconstruction of the breast in a single patient: comparison between mesh and modified dual plane technique

2013 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
Egidio Riggio ◽  
Joseph Ottolenghi ◽  
Veronica Grassi ◽  
Maurizio Nava
Keyword(s):  
Breast Reconstruction ◽  
Acellular Dermal Matrix ◽  
Immediate Breast Reconstruction ◽  
Dermal Matrix ◽  
Dual Plane ◽  
One Stage ◽  
Mesh Reconstruction ◽  
Plane Technique ◽  
Acellular Dermal ◽  
Alloplastic Mesh

Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral immediate breast reconstruction (IBR) with 470 g implants, using alloplastic mesh in one side and the composed dual-plane pocket in the other. In the case described, the composed dual plane technique gave a better result in terms of absence of rippling and smoother surface at the palpation; the mesh coverage gave a better inframammary contour. Our case suggests that the modified dual-plane technique gives a satisfactory cosmetic outcome. It also reduces costs and avoids mesh-related complications. This technique should therefore be considered as an option to the mesh in implant-based breast reconstruction.

Reconstructive and Oncoplastic Surgery

2019 ◽  
pp. 157-165
Author(s):  
Mauricio Magalhães Costa ◽  
Peter van Dam ◽  
Mahmoud Danaei ◽  
Paulo Roberto Leal ◽  
Daniel Leal
Keyword(s):  
Breast Reconstruction ◽  
New Technologies ◽  
Standard Procedure ◽  
Acellular Dermal Matrix ◽  
Immediate Breast Reconstruction ◽  
Fat Grafting ◽  
Oncoplastic Surgery ◽  
Dermal Matrix ◽  
Valid Instrument ◽  
Important Quality

Abstract: Breast reconstruction has evolved over the last century, especially with the advent of new technologies including anatomical implants, expanders, and, most recently, acellular dermal matrix. The development of techniques ranging from free/pedicle flaps, implant-based reconstruction, fat grafting, and oncoplastic surgery have also played a major part in the success of this field. It is important that patients are informed about the possibility of having some type of reconstructive surgery in a second stage. The surgery should be performed by someone with the required training, either a plastic or oncoplastic surgeon, and this is an important quality assurance issue for the patient. Immediate breast reconstruction is gaining wide acceptance. However, secondary reconstruction is also a valid instrument, and in many cases, it is a reference standard procedure.

Citation Analysis in Breast Reconstruction Publications Between 2000 and 2010

2021 ◽  
pp. 229255032110499
Author(s):  
Rebecca Miller ◽  
Sheina Macadam ◽  
Daniel Demsey
Keyword(s):  
Breast Reconstruction ◽  
Citation Analysis ◽  
Case Series ◽  
Acellular Dermal Matrix ◽  
Fat Grafting ◽  
Fat Graft ◽  
Level Of Evidence ◽  
Dermal Matrix ◽  
Number Of Patients ◽  
Acellular Dermal

Introduction and Purpose: Breast reconstruction is an active area of plastic surgery research. Citation analysis allows for quantitative analysis of publications, with more citations presumed to indicate greater influence. We performed citation analysis to evaluate the most cited papers on breast reconstruction between 2000 to 2010 to identify contemporary research trends. Methods: The SCI-EXPANDED database was used to identify the 50 most cited papers. Data points included authorship, publication year, publication journal, study design, level of evidence, number of surgeons/institutions, center of surgery, primary outcome assessed, implant/flap/acellular dermal matrix/fat graft, acellular dermal matrix brand and use with implants/flaps, fat graft use with implants/flaps, unilateral/bilateral, one-/two-stage, immediate/delayed, number of patients/procedures, complications. Descriptive analysis of trends was performed based on results. Results: 20% of papers were published in 2006, 16% in 2007 and 12% in both 2004/2009. 66% were published in Plastic and Reconstructive Surgery. The majority were retrospective or case series, and of Level III or IV evidence. The one Level I study was a prospective multicenter trial. 21 and 7 papers discussed procedures by single/multiple surgeons, respectively. Results from single/multiple centers were discussed in 18 and 6 papers, respectively. 30 papers discussed implant-based reconstruction, 22 papers flap-based (19 microsurgical), 15 papers acellular dermal matrix, and five papers fat grafting. The primary focus in the majority was complications or outcomes. Conclusion: Our analysis demonstrates continually evolving techniques in breast reconstruction. However, there is notable lack of high quality evidence to guide surgical decision-making in the face of increasing surgical options.

Learning curve in immediate breast reconstruction with Strattice acellular dermal matrix

2013 ◽  
Vol 39 (5) ◽  
pp. 464
Author(s):  
Geeta Shetty ◽  
Richard Salisbury ◽  
Ashu Gandhi ◽  
Asid Zeiton ◽  
Richard Johnson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Learning Curve ◽  
Acellular Dermal Matrix ◽  
Immediate Breast Reconstruction ◽  
Dermal Matrix ◽  
Acellular Dermal

scholarly journals Pre-pectoral one-stage breast reconstruction with anterior biological acellular dermal matrix coverage

Gland Surgery ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 1002-1009
Author(s):  
Ayesha Khan ◽  
Marios-Konstantinos Tasoulis ◽  
Victoria Teoh ◽  
Aleksandra Tanska ◽  
Ruth Edmonds ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
One Stage ◽  
Acellular Dermal

Prosthetic-Based Breast Reconstruction

2020 ◽  
Author(s):  
Jonathan Nguyen ◽  
Justin Williams ◽  
Albert Losken
Keyword(s):  
Breast Reconstruction ◽  
Breast Implant ◽  
Tissue Expander ◽  
Acellular Dermal Matrix ◽  
Large Cell ◽  
Fat Grafting ◽  
Immediate Reconstruction ◽  
Dermal Matrix ◽  
Prosthetic Reconstruction ◽  
Acellular Dermal

Prosthetic reconstruction is the most popular option for breast reconstruction after mastectomy. There are several different techniques, such as prepectoral versus subpectoral placement, and delayed versus immediate reconstruction, each with their own sets of risks and benefits. With the advent of improved implant technology, acellular dermal matrix, and fat grafting, prepectoral direct to implant has become an accepted and increasingly popular method of reconstruction, with similar to improved complication rates and outcomes as traditional staged tissue expander reconstruction. Prosthetic reconstruction has had some recent controversies, including breast implant associated anaplastic large cell lymphoma and breast implant illness, and many future studies are being directed towards these topics. This review contains 5 figures, and 53 references. Keywords: breast reconstruction, breast implant, acellular dermal matrix, prepectoral reconstruction, tissue expander, fat grafting, capsular contracture, immediate reconstruction, breast implant associated anaplastic large cell lymphoma, breast implant illness

Ancillary considerations in breast surgery

2021 ◽  
pp. 1145-1150
Author(s):  
Emily G. Clark ◽  
Melissa A. Mueller ◽  
Gregory R.D. Evans
Keyword(s):  
Breast Reconstruction ◽  
Breast Surgery ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Fat Grafting ◽  
Dermal Matrix ◽  
Oncological Safety ◽  
Acellular Dermal ◽  
Radiographic Changes ◽  
Suspicious Lesions

Debated topics and new and evolving techniques in breast surgery are discussed in this chapter. Antibiotics and the use of closed-suction drains vary among surgeons, but the existing evidence favours discontinuation of antibiotics within 24 hours in most cases, and the indications for drains are limited but include breast reconstruction with acellular dermal matrix (ADM). ADM is a biological tissue substitute with many applications in breast surgery. The product selected and surgical technique used are often case specific; cost and patient anatomy play major roles. Although not suitable for all patients, ADM is an asset to prosthetic breast reconstruction. In addition, ADM is useful in the correction of breast surgery complications, including malpositioning and capsular contracture. It may be combined with fat grafting to mask rippling. Fat grafting, or lipomodelling, is an evolving science with promising results. Technique is critical for good results, and is described in this chapter. Radiographic changes after fat grafting are usually discernible from suspicious lesions, and growing evidence supports the oncological safety of this procedure

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