Response to Letter to the Editor Regarding "Prepectoral Breast Reconstruction with Polyurethane-Coated Implants: A 117-Patient Single-Center Study with Objective Cosmetic Evaluation".

We thank Ali for the thoughtful comments regarding our study. We clarify that the study was designed to evaluate polyurethane-coated implants in a real-world prepectoral reconstruction cohort rather than predefined subgroups. Variables highlighted in the Letter were included in the statistical analyses and were not independently associated with complications. We also believe that a substantial learning-curve effect is unlikely because both surgeons had extensive prior experience before initiation of the study cohort. We agree that larger prospective multicenter studies are warranted.Level of Evidence V This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .