Prepectoral Breast Reconstruction: Current Treatment and Future

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 2360

Special Issue Editors


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Guest Editor
1. Department of Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti, Ancona, Italy
2. Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, Jesi, Ancona, Italy
Interests: plastic surgery; aesthetic surgery; reconstructive surgery; breast reconstruction; breast augmentation; oncoplastic surgery

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Guest Editor
Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Department of Medicine (DMED), University of Udine, Udine, Italy
Interests: plastic surgery; reconstructive surgery; microsurgery; free flap; free tissue transfer
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, Department of Medicine (DMED), University of Udine, Udine, Italy
Interests: plastic surgery; reconstructive surgery; microsurgery; free flap; free tissue transfer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Breast cancer surgery and breast reconstruction are probably among the most discussed topics of the past two centuries. The main purpose (and the main difficulty) of breast reconstruction is to restore the shape, volume, and symmetry of both the breast and the nipple areola complex.

Implant-based breast reconstruction is the most popular technique worldwide in post-mastectomy patients.

Techniques involving both two-stage (expander implant) reconstruction and single-stage reconstruction have advanced significantly over the past decade, with excellent aesthetic outcomes consistently being achieved because of improved tools, such as cohesive anatomical implants and acellular dermal matrices.

Prepectoral reconstruction is a technique that eliminates the dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage. Prepectoral breast reconstruction was abandoned in the past due to various complications, but has recently made a resurgence due to the development of acellular dermal matrices and innovative techniques.

Several authors have recently reported positive results with this technique. Nevertheless, an increased complication rate has been reported by other authors. Higher cost compared to non-ADM-assisted breast reconstruction is another concern.

This Special Issue of Medicina entitled “Prepectoral Breast Reconstruction: Current Treatment and Future” welcomes the submission of basic or clinical original articles, as well as systematic reviews, meta-analyses, and overviews, that discuss the limits strengths of breast reconstruction techniques, as well as innovations and evolutions in this field.

Prof. Dr. Michele Riccio
Prof. Dr. Pier Camillo Parodi 
Dr. Nicola Zingaretti 
Guest Editors

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Keywords

  • plastic surgery 
  • aesthetic surgery 
  • reconstructive surgery 
  • breast reconstruction 
  • breast revision 
  • prepectoral implant-based breast reconstruction 
  • meshed ADM 
  • direct to implant 
  • two stage implant based breast reconstruction

Published Papers (1 paper)

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Review

12 pages, 496 KiB  
Review
Outcomes in Hybrid Breast Reconstruction: A Systematic Review
by Mario Alessandri Bonetti, Riccardo Carbonaro, Francesco Borelli, Francesco Amendola, Giuseppe Cottone, Luca Mazzocconi, Alessandro Mastroiacovo, Nicola Zingaretti, Pier Camillo Parodi and Luca Vaienti
Medicina 2022, 58(9), 1232; https://doi.org/10.3390/medicina58091232 - 06 Sep 2022
Cited by 9 | Viewed by 2041
Abstract
Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim [...] Read more.
Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim of the present study is to systematically review available studies in the literature describing the combination of implant-based breast reconstruction and fat grafting, focusing on safety, complications rate, surgical sessions needed to reach a satisfying reconstruction, and patient-reported outcomes. Materials and Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol. A systematic review of the literature up to April 2022 was performed using Medline, Embase, and Cochrane Library databases. Only studies dealing with implant-based breast reconstruction combined with fat grafting were included. Results: We screened 292 articles by title and abstract. Only 48 articles were assessed for full-text eligibility, and among those, 12 studies were eventually selected. We included a total of 753 breast reconstructions in 585 patients undergoing mastectomy or demolitive breast surgeries other than mastectomy (quadrantectomy, segmentectomy, or lumpectomy) due to breast cancer or genetic predisposition to breast cancer. Overall, the number of complications was 60 (7.9%). The mean volume of fat grafting per breast per session ranged from 59 to 313 mL. The mean number of lipofilling sessions per breast ranged from 1.3 to 3.2. Conclusions: Hybrid breast reconstruction shows similar short-term complications to standard implant-based reconstruction but with the potential to significantly decrease the risk of long-term complications. Moreover, patient satisfaction was achieved with a reasonably low number of lipofilling sessions (1.7 on average). Full article
(This article belongs to the Special Issue Prepectoral Breast Reconstruction: Current Treatment and Future)
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