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Implant-Based Immediate Breast Reconstruction: Pre-pectoral vs. Sub-pectoral—An Outcome Analysis

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Abstract

Implant-based breast reconstruction (IBR) is the most common reconstructive procedure after mastectomy. In the last years pre-pectoral IBR gained popularity over the sub-pectoral technique but long-term outcomes are still unavailable. The aim is to compare the clinical outcomes of different approaches to IBR (direct-to-implant (DTI) and expander-to-implant (ETI), pre-pectoral and sub-pectoral techniques). A retrospective review of all patients undergoing immediate IBR from April 2011 to April 2019 under the care of a single plastic surgeon was performed. A total of 106 patients (138 breasts) underwent mastectomy and IBR. Although no significant statistical differences were identified, the incidence of skin necrosis was lower in ETI reconstructions. Pre-pectoral reconstructions had a shorter length of hospital stay. ETI sub-pectoral IBR confirms to be the safest option albeit requiring two surgical procedures. DTI pre-pectoral IBR seems to be related with a higher rate of implant loss if a complication happens. Conversely, in DTI sub-pectoral IBR complications can be more often managed conservatively.

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Authors and Affiliations

  1. Breast Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UK

    Emanuele Garreffa

  2. Breast Unit, Ospedale Civile “Mazzini”, AUSL 4 TE, Teramo, Italy

    Maurizio Brucchi, Antonella Sozio & Guido Torresini

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  1. Emanuele Garreffa
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  2. Maurizio Brucchi
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  3. Antonella Sozio
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  4. Guido Torresini
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Correspondence to Emanuele Garreffa.

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Ethics approval was not necessary for this retrospective study according to Italian law and ethical guidelines.

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Informed consent was obtained by all individual patients included in the study. An additional consent was obtained by the individual participants for whom identifying information is included in this article.

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The authors declare no competing interest.

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Garreffa, E., Brucchi, M., Sozio, A. et al. Implant-Based Immediate Breast Reconstruction: Pre-pectoral vs. Sub-pectoral—An Outcome Analysis. Indian J Surg 83 (Suppl 2), 491–497 (2021). https://doi.org/10.1007/s12262-021-02810-5

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