Direct to implant breast reconstruction with biological acellular dermal matrices

This review discusses the evolution of implant-based breast reconstruction, focusing on the recent trend towards prepectoral reconstruction. Key quality indicators are considered including oncological outcomes, aesthetics and patient-related outcome measures, as well as the healthcare economics.

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Direct to implant breast reconstruction with biological acellular dermal matrices

https://doi.org/10.12968/hmed.2018.0428a 

Victoria Teo & Gerald Gui 

British Journal of Hospital Medicine: Vol. 81, No. 3

Breast reconstruction following mastectomy plays a vital role in restoring quality of life, body confidence and psychosexual wellness in women with breast cancer. In the UK, 21% of women opt for breast reconstruction during their treatment for cancer and this can range from autologous options such as free or pedicled flaps to implant-based reconstruction. Final decisions on reconstruction choices are based on patient choice, body habitus, comorbidities and access to surgical services (NHS Information Centre, 2011).

Implant-based breast reconstruction remains the preferred restorative technique by patients in the UK, with data from 2017 indicating that implant-based reconstruction makes up 70% of the reconstructive caseload (Mylvaganam et al, 2017). The technique of implant-based reconstruction has been the subject of much debate in the last half century, with refinements in implant technology, adjunctive procedures to augment the quality of soft tissue cover, and developments in fat grafting. The ideal anatomical plane for placement of the prostheses remains controversial. The driving force in implant-based reconstruction is the reproduction of a natural breast mound, with recreation of ptosis where necessary and maintenance of projection.

This review focuses on the evolution of implant-based reconstruction, drawing on the resurgence of prepectoral implant-based reconstruction. It discusses contemporary key quality indicators in the literature including oncological outcomes, breast aesthetics and patient-related outcome measures, and discusses the health-care economics of this emerging surgical technique.

Direct to implant breast reconstruction with biological acellular dermal matrices

https://doi.org/10.12968/hmed.2018.0428a
Victoria Teo & Gerald Gui
British Journal of Hospital Medicine: Vol. 81, No. 3


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