Our Summary

The research paper is about a study comparing two methods of breast reconstruction surgery: subpectoral breast reconstruction (SPBR) and prepectoral breast reconstruction (PPBR). Past views suggested that PPBR had a high risk of complications and was not suitable for clinical use. However, with the introduction of a new technique using acellular dermal matrix (ADM), PPBR’s clinical outcomes have improved.

The researchers collected and analyzed data from various sources, including PubMed, Web of Sciences, Embase, and Cochrane databases, to compare the results of SPBR and PPBR. They focused on the rates of complications and the duration of drainage (time it takes for fluid to stop leaking from the surgery site).

The analysis showed that SPBR had a higher rate of specific complications, including capsular contracture (hardening of tissue around the implant), animation deformity (abnormal movement of the breast when the chest muscles are used), infection, blood accumulation (hematoma), and slow wound healing. However, there was no significant difference between the two methods in terms of skin flap necrosis (death of skin tissue), seroma (collection of serous fluid in a pocket under the skin), implant loss, reoperation, and duration of drainage.

In simpler terms, the study suggests that PPBR is no longer considered a high-risk surgery and can be used in clinical practice. However, more research is needed as the current studies have small sample sizes.

FAQs

  1. What is the difference between subpectoral breast reconstruction (SPBR) and prepectoral breast reconstruction (PPBR)?
  2. What were the key findings of the comparison between SPBR and PPBR in terms of complication rates?
  3. Are there any significant differences in skin flap necrosis, seroma, implant loss, reoperation and duration of drainage between SPBR and PPBR?

Doctor’s Tip

A helpful tip for a patient considering breast reconstruction is to discuss with their doctor the option of prepectoral breast reconstruction, as it has been shown to have comparable outcomes to subpectoral reconstruction with lower rates of certain complications. It is important to have an open and thorough discussion with your doctor about the best option for your individual situation.

Suitable For

Patients who are typically recommended for breast reconstruction are those who have undergone mastectomy for breast cancer, have a genetic predisposition to breast cancer, or have experienced trauma or other medical conditions that have resulted in breast deformity. These patients may desire to restore their breast shape, size, and symmetry through breast reconstruction surgery. The decision to undergo breast reconstruction is a personal one and should be made in consultation with a plastic surgeon, oncologist, and other healthcare providers.

Timeline

  1. Diagnosis of breast cancer and decision to undergo mastectomy
  2. Consultation with a plastic surgeon to discuss breast reconstruction options
  3. Surgery for mastectomy
  4. Recovery period after mastectomy
  5. Consultation with plastic surgeon to discuss breast reconstruction options, including subpectoral or prepectoral placement of implants
  6. Surgery for breast reconstruction
  7. Recovery period after breast reconstruction surgery
  8. Follow-up appointments with plastic surgeon for monitoring and adjustments, if needed
  9. Continued monitoring for any complications or issues related to the breast reconstruction

Overall, the timeline for a patient before and after breast reconstruction surgery can vary depending on individual circumstances and the specific type of reconstruction chosen. It is important for patients to work closely with their medical team to ensure the best possible outcome and to address any concerns or questions throughout the process.

What to Ask Your Doctor

  1. What are the different options for breast reconstruction, and which one do you recommend for me?
  2. What are the potential risks and complications associated with breast reconstruction surgery?
  3. How long is the recovery period after breast reconstruction surgery?
  4. Will I need additional surgeries or procedures in the future after breast reconstruction?
  5. How will breast reconstruction affect the appearance and feel of my breasts?
  6. Are there any limitations on physical activity or lifestyle changes I should be aware of after breast reconstruction?
  7. How will breast reconstruction impact the sensitivity of my breasts or nipples?
  8. What are the long-term effects of breast reconstruction, and are there any potential risks for complications in the future?
  9. Can breast reconstruction be performed at the same time as mastectomy, or will it need to be done in a separate surgery?
  10. Are there any alternatives to implant-based breast reconstruction that I should consider?

Reference

Authors: Xie J, Wang M, Cao Y, Zhu Z, Ruan S, Ou M, Yu P, Shi J. Journal: J Plast Surg Hand Surg. 2023 Feb-Dec;57(1-6):7-15. doi: 10.1080/2000656X.2021.1981351. Epub 2021 Sep 28. PMID: 34581645