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Outcomes of prepectoral implant-based breast reconstruction with Braxon® acellular dermal matrix—a single-centre experience

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Abstract

Background

Single-stage direct-to-implant reconstruction is the most common method of reconstruction in the UK after a mastectomy. Prepectoral implant placement with full implant coverage using acellular dermal matrix (ADM) is a relatively new technique. We report on long-term outcomes of prepectoral immediate breast reconstruction (IBR) using Braxon® ADM from a single institution.

Methods

All patients operated for a mastectomy with IBR using Braxon® from January 2016 to March 2018 were included in the study. The demographic details, treatment details and short- and long-term outcomes were evaluated. Factors affecting complication rates were analysed. Patient-reported outcome measures were studied using BREAST-Q questionnaires.

Results

One hundred and sixteen reconstructions performed in 98 patients were included in the study. The median age was 50 years with a mean body mass index of 27.33 kg/m2. The median follow-up period was 440 days. The implant-related major complication rate was 17%, with an unplanned readmission rate of 22.4% and a return to theatre rate of 21.4%. Early complications were significantly higher in patients with node-positive disease. Delayed complications were seen in nine patients. The implant loss rate was 4.3%. The mean BREAST-Q scores were 78 for satisfaction with treatment and 64 for satisfaction with breast domains. The outcomes were comparable to reported national data.

Conclusions

Prepectoral implant-based reconstruction with Braxon has comparable complication rates with good long-term aesthetic and patient-reported outcomes. Further studies with larger cohort and longer follow-up are needed.

Level of Evidence—Level III, therapeutic study.

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Author information

Author notes

  1. Mihir Chandarana and Soni Soumian contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Forth Valley Royal Hospital, Larbert, UK

    Mihir Chandarana

  2. Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, UK

    Soni Soumian, Sadaf Jafferbhoy, Sekhar Marla & Sankaran Narayanan

  3. Department of General Surgery, University Hospital North Midlands, The Royal Stoke University Hospital, Trust Headquarters Building, Stoke on Trent, ST4 6QG, UK

    Soni Soumian

Authors
  1. Mihir Chandarana
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  2. Soni Soumian
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  4. Sekhar Marla
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  5. Sankaran Narayanan
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Corresponding author

Correspondence to Soni Soumian.

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Conflict of interest statement

Mihir Chandarana, Soni Soumian, Sadaf Jafferbhoy, Sekhar Marla and Sankaran Narayanan declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Patients provided written consent for the use of their images.

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The study has no source of funding.

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Chandarana, M., Soumian, S., Jafferbhoy, S. et al. Outcomes of prepectoral implant-based breast reconstruction with Braxon® acellular dermal matrix—a single-centre experience. Eur J Plast Surg 42, 431–438 (2019). https://doi.org/10.1007/s00238-019-01512-2

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  • DOI: https://doi.org/10.1007/s00238-019-01512-2

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