Long term follow-up on prepectoral ADM-assisted breast reconstruction: evidences after 4 years

Abstract

Prepectoral implant-based breast reconstruction is on the rise because of the advantages related to preservation of the pectoralis major muscle. Indeed, this reconstructive procedure improves the aesthetic outcomes and the postoperative recovery time, avoiding the risk of breast animation and deformity. On the other hand, the subcutaneous implant positioning has higher risk of capsular contracture and for this reason, the subpectoral breast reconstruction has been preferred for many years; but the introduction of a pre-shaped acellular dermal matrix (ADM) which allows a complete implant coverage led to the onset of the new prepectoral technique, solving the problem of a stiff periprosthetic capsule formation. In fact, the use of ADMs in breast reconstruction has been shown to decrease the capsular contracture formation. Nevertheless, no long-term outcomes have been reported with the use of a pre-shaped ADM for prepectoral breast reconstruction. The authors present the first ten patients who had a prepectoral ADM-assisted breast reconstruction showing no evidences of capsular contracture after a median follow-up of 4 years.

Level of Evidence: Level V, therapeutic study.

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