Abstract
Although skin- or nipple-sparing mastectomy has been popular in the treatment of breast cancer, the radical excision of breast tissue is unavoidable in certain circumstances. However, the ability of an acellular dermal matrix (ADM) to expand remains questionable, and this situation may further hinder tissue expansion. From October 2017 to January 2020, patients who underwent immediate breast reconstruction with tissue expander placement using ADM whose initial fill volume was less than 50 mL were retrospectively reviewed. The primary outcomes were the number of visits and number of days required to complete the expansion, and the secondary outcomes were the amount of postoperative expansions, expander fill ratio and expander volume. Between the prepectoral group (n = 26) and subpectoral group (n = 39), the mean number of days (81.46 days versus 88.64 days, p = 0.365) and mean number of visits (5.08 versus 5.69, p = 0.91) required to complete expansion exhibited no significant differences. Additionally, there were no significant differences in the mean amount of postoperative expansion (314.23 mL versus 315.38 mL, p = 0.950), the mean final volume (353.08 mL versus 339.62 mL, p = 0.481) or the mean final volume ratio (0.89 versus 0.86, p = 0.35) between the two groups. Therefore, we suggest that prepectoral tissue expander placement after conventional mastectomy can be a valid option.
Highlights
The reconstruction of the breast after mastectomy remains one of the major topics in plastic surgery [1]
Med. 2021, 10, 4502 cell carcinoma in situ (DCIS) was the most common tumor stage in the prepectoral group, whereas stage I and stage II tumors were predominant in the subpectoral group (Table 1)
Hnaotwureev. eTrh, enroefodrieff,eirteins cneost wfreeere found in the number of visits or days required for the completion of the expansion. These findings indicate that acellular dermal matrix (ADM) does not hinder breast tissue expansion
Summary
The reconstruction of the breast after mastectomy remains one of the major topics in plastic surgery [1]. Subpectoral placement has been the chosen method for the majority of prosthetic device placements [3]. This procedure involves the devices being placed under the pectoralis major muscle, wherein the lower pole is covered with or without an acellular dermal matrix (ADM). Such a procedure enables the pectoralis major muscle to act as a soft tissue barrier for prosthetic devices, decreasing the possibilities of implant extrusion, rippling or capsular contracture. Patients undergoing radiotherapy have been shown to suffer a higher risk of implant displacement due to fibrosis of the pectoralis major muscle [5,6]
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