PC58. Soft Tissue Support in Prepectoral Breast Reconstruction: Do We Need It?

Abstract

PURPOSE: Soft tissue support (STS) has contributed to the rise of prepectoral breast reconstruction, but little is known about its impact on outcomes. METHODS: A chart review of all consecutive, prepectoral breast reconstructions performed between March 2017 and July 2022 at a single center was conducted. Demographics, operative characteristics, and complications were extracted for all patients. Multivariate logistic regression was used to predict complications while controlling for STS. A p<0.05 was considered statistically significant. RESULTS: A total of 226 patients (371 breasts) were included. STS was used in 145 (39%) breasts. Type of STS included ADM (52%), ADM and vicryl mesh (35%), polydioxanone mesh (6%), and other (7%). On average, women were 52 years old, never smoker (67%), non-diabetic (92%), and had a body mass index of 28. All breasts underwent immediate reconstruction, using tissue expanders (TEs, 74%) or a direct-to-implant (DTI, 26%) approach. Sixty-nine (19%) breasts were radiated (77% adjuvant, 20% neoadjuvant, 3% both), and 95 (42%) patients received chemotherapy (19% adjuvant, 13% neoadjuvant, 10% both).On univariate analysis, STS was associated with fewer minor complications, less partial NAC necrosis, and fewer seromas. In multivariate analysis, STS was associated with fewer minor complications (0.31 [0.14-0.62], p<0.01) and fewer seromas (0.34 [0.11-0.89], p = 0.04). CONCLUSION: STS in prepectoral breast reconstruction may reduce postoperative complications.