Breast reconstruction is part of the therapeutic program in case of breast cancer. Over the years, technical-scientific progress in medical and surgical field has increased the possibilities and the options of post-oncological breast reconstruction.
The use of resorbable acellular dermal matrices (ADMs) has made possible implant positioning in a supramuscular plane (prepectoral breast reconstruction), avoiding the surgical detachment of the Pectoralis Major muscle (muscle sparing), reducing post-surgical pain, bleeding and hospitalization times.
Our Center is one of the main in Italy that performs prepectoral breast reconstruction with acellular dermal matrices, boasting a surgical experience of over 6 years.
The purpose of this study is to evaluate the results of the post-oncological breast reconstruction with ADM and smooth surface implants in terms of: complication rate such as hematoma, seroma, capsular contracture, infections, wound dehiscence, rippling; aesthetic outcome; patient satisfaction and surgeon satisfaction (the latters evaluated through specific questionnaires).
The purpose of this study is to evaluate the relationship between the use of acellular dermal matrices (ADMs) and the type of surface of breast prosthesis implanted during prepectoral breast reconstruction. Moreover, we want to evaluate results and complications in terms of: complication rate at 1 month, 3 months, 6 months, 1 year such as hematoma, seroma, capsular contracture, infections, wound dehiscence, rippling; aesthetic outcome; patient satisfaction and surgeon satisfaction (the latters evaluated through specific questionnaires).
In surgical practice many operators prefer to use textured breast implants (anatomical or round) for the advantages that texturing brings: reduction of the capsular contracture rate and reduction of dislocation or prosthetic rotation. Furthermore, textured anatomical implants have the advantage of giving a more natural look to the reconstructed breast.
The present study aims to investigate the results of a prepectoral breast reconstruction with smooth surface implants coated with ADM. The implant coverage provided by the ADM avoids the contact of the implant surface itself with the host tissues and stimulates the integration of the matrix and the formation of the periprosthetic capsule.
The absence of texturing, and therefore of pores, in smooth surface implants reduces the formation of biofilm and reduces the implant contact surface with the host tissues, consequently reducing the inflammatory reaction towards the foreign body. All this in addition to the coating provided by the acellular dermal matrix that wraps the implant itself.
There are no studies in the literature that correlate the use of acellular dermal matrices with the type of surface of the prosthesis in prepectoral breast reconstruction.