Plastic and reconstructive surgery · 2025
One-Year Outcomes in Prepectoral versus Subpectoral Alloplastic Breast Reconstruction.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Vingan Perri S, Kim Minji, Boe Lillian A, Coriddi Michelle R, Allen Robert J, Disa Joseph J, Stern Carrie S, Matros Evan, Mehrara Babak J, Nelson Jonas A
Аннотация
BACKGROUND: Prepectoral and subpectoral approaches to implant-based breast reconstruction (IBBR) are both reliable options after mastectomy. In this study, the authors compared 1-year complication rates, additional or revision procedures, and patient-reported outcomes between 2-stage prepectoral or subpectoral IBBR through propensity matching.
METHODS: Female patients who underwent prepectoral or subpectoral 2-stage IBBR from January of 2017 to June of 2022 with BREAST-Q scores available 1 year after exchange were reviewed. Complication rates, additional or revision procedures at the time of exchange and within 1 year of exchange, and BREAST-Q scores preoperatively and at 1 year were compared between patient groups. Propensity score-matched analyses were used to reduce possible confounding or selection bias related to nonrandomized treatment assignment of patients.
RESULTS: Of 1732 overall patients, 878 patients were included in the matched analysis (439 in each cohort). Patients with prepectoral IBBR had significantly higher rates of implant-related cellulitis or infection (5.5% versus 1.8%; P = 0.008) and implant exposure (2.3% versus 0.2%; P = 0.016) compared with patients with subpectoral IBBR, and more commonly had fat grafting at the time of the exchange procedure. On BREAST-Q, Physical Well-Being of the Chest at 1 year was significantly higher in the patients with prepectoral IBBR (median, 80 [interquartile range, 64, 92] versus 76 [64, 85]; P < 0.001). No other differences in BREAST-Q outcomes were observed.
CONCLUSION: In this powered analysis comparing prepectoral and subpectoral implant reconstruction at 1 year, the authors found that patients with prepectoral IBBR experienced higher rates of complications, such as infection or implant exposure, after implant exchange but had improved health-related quality of life as defined by the BREAST-Q Physical Well-Being of the Chest domain.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
METHODS: Female patients who underwent prepectoral or subpectoral 2-stage IBBR from January of 2017 to June of 2022 with BREAST-Q scores available 1 year after exchange were reviewed. Complication rates, additional or revision procedures at the time of exchange and within 1 year of exchange, and BREAST-Q scores preoperatively and at 1 year were compared between patient groups. Propensity score-matched analyses were used to reduce possible confounding or selection bias related to nonrandomized treatment assignment of patients.
RESULTS: Of 1732 overall patients, 878 patients were included in the matched analysis (439 in each cohort). Patients with prepectoral IBBR had significantly higher rates of implant-related cellulitis or infection (5.5% versus 1.8%; P = 0.008) and implant exposure (2.3% versus 0.2%; P = 0.016) compared with patients with subpectoral IBBR, and more commonly had fat grafting at the time of the exchange procedure. On BREAST-Q, Physical Well-Being of the Chest at 1 year was significantly higher in the patients with prepectoral IBBR (median, 80 [interquartile range, 64, 92] versus 76 [64, 85]; P < 0.001). No other differences in BREAST-Q outcomes were observed.
CONCLUSION: In this powered analysis comparing prepectoral and subpectoral implant reconstruction at 1 year, the authors found that patients with prepectoral IBBR experienced higher rates of complications, such as infection or implant exposure, after implant exchange but had improved health-related quality of life as defined by the BREAST-Q Physical Well-Being of the Chest domain.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.