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

Histologic Analysis of Fetal Bovine Derived Acellular Dermal Matrix in Tissue Expander Breast Reconstruction

2013 ◽  
Vol 70 (4) ◽  
pp. 447-453 ◽  
Author(s):  
Richard S. Gaster ◽  
Aaron J. Berger ◽  
Stefanie D. Monica ◽  
Robert T. Sweeney ◽  
Ryan Endress ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tissue Expander ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Histologic Analysis ◽  
Fetal Bovine ◽  
Acellular Dermal

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.

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

scholarly journals Immediate Implant-based Breast Reconstruction with Acellular Dermal Matrix Compared with Tissue-expander Breast Reconstruction

2018 ◽  
Vol 6 (12) ◽  
pp. e1949 ◽  
Author(s):  
Marcello Carminati ◽  
Darja Sempf ◽  
Pier Paolo Bonfirraro ◽  
Luca Devalle ◽  
Maurizio Verga ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tissue Expander ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Immediate Implant ◽  
Acellular Dermal

scholarly journals Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jessica F. Rose ◽  
Sarosh N. Zafar ◽  
Warren A. Ellsworth IV
Keyword(s):  
Breast Reconstruction ◽  
Skin Necrosis ◽  
Tissue Expander ◽  
Retrospective Chart Review ◽  
Acellular Dermal Matrix ◽  
Complication Rates ◽  
Dermal Matrix ◽  
Drain Removal ◽  
Dermal Matrices ◽  
Acellular Dermal

Background. While the benefits of using acellular dermal matrices (ADMs) in breast reconstruction are well described, their use has been associated with additional complications. The purpose of this study was to determine if ADM thickness affects complications in breast reconstruction. Methods. A retrospective chart review was performed including all tissue expander based breast reconstructions with AlloDerm (LifeCell, Branchburg, NJ) over 4 years. We evaluated preoperative characteristics and assessed postoperative complications including seroma, hematoma, infection, skin necrosis, and need for reintervention. We reviewed ADM thickness and time to Jackson-Pratt (JP) drain removal. Results. Fifty-five patients underwent 77 ADM-associated tissue expander based breast reconstructions, with average age of 48.1 years and average BMI of 25.9. Average ADM thickness was 1.21 mm. We found higher complication rates in the thick ADM group. Significant associations were found between smokers and skin necrosis (p<0.0001) and seroma and prolonged JP drainage (p=0.0004); radiated reconstructed breasts were more likely to suffer infections (p=0.0085), and elevated BMI is a significant predictor for increased infection rate (p=0.0037). Conclusion. We found a trend toward increased complication rates with thicker ADMs. In the future, larger prospective studies evaluating thickness may provide more information.

scholarly journals Local reaction to FlexHD® acellular dermal matrix in breast reconstruction: A case report and review of the literature

2018 ◽  
Vol 1 (1) ◽  
pp. 142-148
Author(s):  
Robert Phan ◽  
Frank Lin ◽  
Dean White
Keyword(s):  
Breast Reconstruction ◽  
Medical Literature ◽  
Local Reaction ◽  
Breast Implant ◽  
Acellular Dermal Matrix ◽  
Abdominal Wall Defects ◽  
Review Of The Literature ◽  
Dermal Matrix ◽  
Thoracic And Abdominal ◽  
Acellular Dermal

Since its first reported use for the treatment of burns victims, acellular dermal matrix (ADM) use has expanded to surgeries including repairing thoracic and abdominal wall defects, and breast reconstruction. FlexHD® is a brand of ADM prepared from human cadaveric dermis that has been processed to remove antigenic components and is used to reinforce the subpectoral pocket created during submuscular breast implant surgery. Recent documentation of a phenomenon termed ‘red breast syndrome’ (RBS) has emerged in the medical literature, with little known about its aetiology and treatment. This paper presents a case of blistering cutaneous erythema from FlexHD® ADM.

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