Article ; Online: Long-Term Outcomes in Prepectoral versus Subpectoral Two-Stage Implant-Based Breast Reconstruction after Nipple-Sparing Mastectomy.
Plastic and reconstructive surgery
2023 Volume 152, Issue 2, Page(s) 273–280
Abstract: Background: Implant-based breast reconstruction remains the most often used method following mastectomy, but data are lacking regarding differences in complications and long-term patient-reported outcomes for two-stage subpectoral versus prepectoral ... ...
| Abstract | Background: Implant-based breast reconstruction remains the most often used method following mastectomy, but data are lacking regarding differences in complications and long-term patient-reported outcomes for two-stage subpectoral versus prepectoral reconstruction. This study sought to better understand the risks and impact of these reconstructive approaches on overall satisfaction. Methods: Patients who underwent unilateral or bilateral nipple-sparing mastectomy and two-stage implant-based reconstruction from 2014 to 2019 were identified from the electronic medical records and contacted via email to complete the BREAST-Q survey. Overall satisfaction was measured by the question, "How happy are you with the outcome of your breast reconstruction?" using a six-point Likert scale. Patients were grouped into subpectoral or prepectoral cohorts. Complications were evaluated retrospectively. Only patients who were at least 6 months from their final reconstruction were included in the analysis. Results: Of the 582 patients contacted, 206 (35%) responded. The subpectoral ( n = 114) and prepectoral ( n = 38) groups did not differ significantly by demographic or treatment characteristics. BREAST-Q scores were also comparable. Complication rates were similar, but prepectoral patients had a significantly higher rate of capsular contracture (16% versus 4%, P < 0.05). Bivariate ordered logistic regression identified prepectoral implant placement, having any postoperative complication, and capsular contracture as predictors of less overall happiness. Conclusions: The authors' study suggests that prepectoral patients may have slightly higher complication rates but are as satisfied as subpectoral patients after at least a year of follow-up. Further studies should investigate risk factors for capsular contracture, how the risk changes over time, and how the risk affects patient satisfaction. |
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| MeSH term(s) | Humans ; Female ; Mastectomy/adverse effects ; Mastectomy/methods ; Breast Implantation/adverse effects ; Breast Implantation/methods ; Breast Implants/adverse effects ; Retrospective Studies ; Nipples/surgery ; Breast Neoplasms/surgery ; Breast Neoplasms/etiology ; Mammaplasty/adverse effects ; Mammaplasty/methods ; Contracture/etiology |
| Language | English |
| Publishing date | 2023-02-01 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 208012-6 |
| ISSN | 1529-4242 ; 0032-1052 ; 0096-8501 |
| ISSN (online) | 1529-4242 |
| ISSN | 0032-1052 ; 0096-8501 |
| DOI | 10.1097/PRS.0000000000010251 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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