Our Summary

This research paper aims to evaluate the safety and impact on quality of life of a procedure called “direct-to-implant subcutaneous breast reconstruction.” This method of reconstructing the breast has become more popular over the years. The researchers also compared the complications of this technique with another method, submuscular breast reconstruction.

The research involved analyzing data from various studies that met certain criteria. The data was collected from 2863 patients and 3988 breasts that had undergone the subcutaneous reconstruction. The researchers looked at various complications that could occur after the surgery, such as rippling, seroma (fluid buildup), hematoma (blood pooling outside of blood vessels), infection, wound dehiscence (wound splitting open), skin necrosis (skin tissue death), nipple-areolar-complex necrosis (death of nipple and areola tissue), capsular contracture (scar tissue squeezing the implant), animation deformity (unwanted movement of the breast when the chest muscle moves), and implant removal.

The research found that there was no animation deformity but a higher risk of rippling with the subcutaneous method. However, it does not negatively affect the patient’s quality of life compared to the submuscular method. The subcutaneous method also has the advantage of preserving the pectoral muscle and preventing unwanted breast movement when the chest muscle moves.

FAQs

  1. What is “direct-to-implant subcutaneous breast reconstruction” and how does it differ from submuscular breast reconstruction?
  2. What potential complications were evaluated in the research regarding subcutaneous breast reconstruction?
  3. What were the findings of the research in terms of safety and quality of life impact for patients undergoing subcutaneous breast reconstruction?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast reconstruction is to discuss with their surgeon the different reconstructive options available, including the direct-to-implant subcutaneous method. It is important for patients to understand the potential risks and benefits of each technique in order to make an informed decision about their reconstruction. Additionally, patients should be aware that while there may be a higher risk of rippling with the subcutaneous method, it does not negatively impact their quality of life. Ultimately, the choice of reconstructive method should be based on individual preferences and goals for breast reconstruction.

Suitable For

Patients who are typically recommended for breast reconstruction include those who have undergone a mastectomy (surgical removal of the breast) due to breast cancer or other medical conditions. Additionally, patients who have a high risk of developing breast cancer, such as those with a strong family history of the disease or a genetic mutation like BRCA1 or BRCA2, may also be recommended for breast reconstruction as a preventative measure.

Patients who have a desire to restore the appearance of their breasts after mastectomy and improve their self-esteem and quality of life are also good candidates for breast reconstruction. It is important for patients to have realistic expectations about the outcomes of the procedure and to be in good overall health to undergo surgery.

Ultimately, the decision to undergo breast reconstruction is a personal one and should be made in consultation with a qualified healthcare provider who can provide information and guidance based on the individual patient’s medical history and preferences.

Timeline

Before breast reconstruction:

  • Patient is diagnosed with breast cancer or undergoes a mastectomy due to other reasons
  • Patient discusses options for breast reconstruction with their healthcare provider
  • Patient undergoes consultations with a plastic surgeon to determine the best reconstruction technique for them
  • Patient makes a decision on the type of reconstruction they want, whether it be implants, autologous tissue transfer, or a combination of both
  • Patient undergoes the breast reconstruction surgery

After breast reconstruction:

  • Patient may experience pain, swelling, and bruising in the surgical area
  • Patient may need to stay in the hospital for a few days after surgery
  • Patient will have follow-up appointments with their plastic surgeon to monitor healing and address any complications
  • Patient may need to undergo additional procedures for symmetry, nipple reconstruction, or scar revision
  • Patient gradually resumes normal activities and adjusts to their new appearance
  • Patient may undergo additional procedures in the future to maintain or improve the results of the reconstruction
  • Patient experiences improved self-esteem, body image, and quality of life after the successful completion of breast reconstruction.

What to Ask Your Doctor

Some questions a patient should ask their doctor about breast reconstruction include:

  1. What are the different types of breast reconstruction options available, and which one do you recommend for me?
  2. What are the potential risks and complications associated with the direct-to-implant subcutaneous breast reconstruction method?
  3. How does the subcutaneous method compare to the submuscular method in terms of safety and outcomes?
  4. What is the recovery process like after undergoing direct-to-implant subcutaneous breast reconstruction?
  5. Will I need additional procedures or touch-ups in the future with this method?
  6. How will the appearance and feel of my reconstructed breast compare to my natural breast?
  7. What are the long-term effects and considerations of choosing the subcutaneous method for breast reconstruction?
  8. Are there any lifestyle changes or limitations I should be aware of after undergoing this procedure?
  9. How experienced are you in performing direct-to-implant subcutaneous breast reconstruction, and what is your success rate with this method?
  10. Can you provide me with before and after photos of patients who have undergone this type of breast reconstruction?

Reference

Authors: Silva J, Carvalho F, Marques M. Journal: Aesthetic Plast Surg. 2023 Feb;47(1):92-105. doi: 10.1007/s00266-022-03068-2. Epub 2022 Sep 12. PMID: 36097081