Abstract

Simple SummaryImmediate implant-based postmastectomy breast reconstruction (IPMBR) with contralateral symmetrization has mostly short-term limited evidence of cosmetic outcomes. Ageing after IPMBR and symmetrization may contribute to symmetry worsening. This non-interventional retrospective correlational study presents the clinical and aesthetic results of synthetic ULTRAPRO® mesh inner bra sling symmetrization mastopexy with standard mastopexies. A total of 59 patients were enrolled in the mesh group (MG), and 58 patients were enrolled in the non-mesh group (NMG). There were no significant differences in surgical complications (p = 0.521; chi-square. The median sternal notch-to-nipple distance difference was 1 cm in the MG and 3.5 cm in the NMG from the last follow-up, and the median nipple-to-inferior mammary fold distance differences were 0.5 cm and 0.75 cm. ULTRAPRO® mesh sling symmetrization can be successfully used to decrease pseudoptosis and nipple down-migration, offering a safe alternative for long-lasting symmetry and high patient satisfaction.Immediate implant-based postmastectomy breast reconstruction (IPMBR) with contralateral symmetrization has mostly short-term limited evidence of cosmetic outcomes. Because 84% of early-stage breast cancer patients have overall survival of more than 10 years, reconstructed breast symmetry should provide long-lasting results and acceptable patient satisfaction. Ageing, changes in body weight, and biomechanical changes after IPMBR and symmetrization may contribute to symmetry worsening. This non-interventional single-centre retrospective correlational study presents the clinical and aesthetic results of synthetic ULTRAPRO® mesh inner bra sling symmetrization mastopexy with standard mastopexies. According to the results, a total of 59 patients were enrolled in the mesh group (MG), and 58 patients were enrolled in the non-mesh group (NMG). There were no significant differences in surgical complications (p = 0.521; chi-square). The median sternal notch-to-nipple distance difference was 1 cm in the MG and 3.5 cm in the NMG from the last follow-up, and the median nipple-to-inferior mammary fold distance differences were 0.5 cm and 0.75 cm. The mesh did not hinder the follow-up investigation. In conclusion, ULTRAPRO® mesh sling symmetrization can be successfully used to decrease pseudoptosis and nipple down-migration, offering a safe alternative for long-lasting symmetry and high patient satisfaction.

Highlights

  • The goal of modern breast reconstruction surgery is to immediately replace the missing breast volume, reshape the distorted contours, and create optimal symmetry by modelling the contralateral breast

  • The applied oncological therapies were unaffected by the study and followed up-to-date institutional treatment protocols according to the European Society of Medical Oncology (ESMO) guidelines [22]

  • More reduction mastopexy procedures were performed in the mesh group (MG) than in the non-mesh group (NMG) (p = 0.032; chi-square), and significantly larger implants were used on the mastectomy side in the MG (p = 0.012; Mann–Whitney)

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Summary

Introduction

The goal of modern breast reconstruction surgery is to immediately replace the missing breast volume, reshape the distorted contours, and create optimal symmetry by modelling the contralateral breast. Aesthetic and symmetrical breasts are realistic expectations for most breast cancer patients following all kinds of postmastectomy breast reconstruction (PMBR). The time value of the cosmetic outcome seems to be more problematic with limited clinical and patient-related outcomes in the long term [3]. Symmetrization techniques have only mid-level and short-term evidence according to oncological and cosmetic outcomes. Maintaining long-lasting symmetry remains a challenge, basically because of mainstream immediate implant-based postmastectomy breast reconstruction (IPMBR) on the cancerous side versus the different structure of the natural breast on the contralateral side [4,5]

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