Our Summary

This research paper explores a popular method of breast reconstruction surgery called pre-pectoral implant-based breast reconstruction. While this method offers several advantages such as ideal implant positioning and reduced discomfort for the patient, there are concerns about a higher risk of breast implant rippling. This is a condition where the skin over the implant appears wavy or wrinkled, often leading to additional surgery to correct it.

In the study, the researchers examined previous studies and literature to understand the rate of rippling in this type of breast reconstruction. The results showed that the rate of rippling varied greatly, from 0 to 53.8%. Most of the studies didn’t find a significant link between a patient’s Body Mass Index (BMI) and the risk of rippling, suggesting other factors were at play.

The researchers then looked into specific surgical techniques that might help reduce the risk of rippling. They found that paying close attention to things like the protocol for expanding the pocket for the implant, the properties of the implant, and the use of adjunctive procedures could potentially lower the risk of rippling.

In conclusion, the study suggests that by making certain modifications to the surgical process, surgeons may be able to reduce the incidence of rippling in pre-pectoral breast reconstruction.

FAQs

  1. What is pre-pectoral implant-based breast reconstruction and what are its advantages?
  2. What is breast implant rippling and what factors contribute to its occurrence?
  3. How can the risk of rippling be potentially reduced in pre-pectoral breast reconstruction surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast reconstruction is to discuss the potential risks and benefits of different surgical techniques, including the risk of rippling, with their surgeon before undergoing the procedure. By being informed and proactive, patients can work with their healthcare team to make the best decisions for their individual situation.

Suitable For

Patients who are typically recommended for breast reconstruction are those who have undergone a mastectomy for breast cancer treatment, have a genetic predisposition to breast cancer (such as BRCA gene mutation carriers), or have experienced trauma or injury to the breast. Additionally, patients who desire breast reconstruction for aesthetic reasons or to restore symmetry between their breasts may also be recommended for the procedure. Ultimately, the decision to undergo breast reconstruction is a personal one, and patients should discuss their options with their healthcare provider to determine the best course of action for their individual circumstances.

Timeline

Before breast reconstruction:

  • Patient is diagnosed with breast cancer and decides to undergo a mastectomy
  • Patient consults with a plastic surgeon to discuss options for breast reconstruction
  • Patient and surgeon decide on a plan for reconstruction, including the use of pre-pectoral implant-based reconstruction
  • Patient undergoes mastectomy surgery

After breast reconstruction:

  • Surgeon performs pre-pectoral implant-based breast reconstruction surgery
  • Patient may experience some discomfort and swelling post-surgery
  • Patient follows a recovery plan, including rest and limited activity
  • Patient attends follow-up appointments with the surgeon to monitor healing and address any concerns
  • Patient may need additional procedures to address complications such as implant rippling
  • Patient continues with regular follow-up appointments to monitor the health and appearance of the reconstructed breast.

What to Ask Your Doctor

Questions a patient should ask their doctor about breast reconstruction, specifically pre-pectoral implant-based breast reconstruction, include:

  1. What are the potential risks and complications associated with pre-pectoral implant-based breast reconstruction, including the risk of breast implant rippling?
  2. What is the estimated rate of breast implant rippling in pre-pectoral implant-based breast reconstruction, based on current research and studies?
  3. Are there any specific factors that may increase my risk of experiencing breast implant rippling after surgery?
  4. What surgical techniques or modifications can be made during the procedure to help reduce the risk of breast implant rippling?
  5. How will you determine the best implant size, shape, and type for my pre-pectoral implant-based breast reconstruction to minimize the risk of rippling?
  6. What is the expected recovery time and post-operative care plan for pre-pectoral implant-based breast reconstruction, and how will rippling be monitored and addressed during follow-up appointments?
  7. Are there any alternative breast reconstruction options that may have a lower risk of rippling, and how do they compare to pre-pectoral implant-based breast reconstruction in terms of outcomes and complications?

Reference

Authors: Tevlin R, Sharma AD, Griffin M, Wan D, Momeni A. Journal: Aesthetic Plast Surg. 2023 Dec;47(6):2351-2359. doi: 10.1007/s00266-023-03616-4. Epub 2023 Sep 13. PMID: 37704858