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

Abstract

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. 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. 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. 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.