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The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction

Prepectoral implant-based breast reconstruction has become more common given the reduced dissection, decreased postoperative pain, elimination of animation deformity, and improved aesthetics compared with subpectoral reconstructions. Despite these benefits, surgeons must contend with increased rates...

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Autor principal: Schwartz, Jean-Claude D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010849/
https://www.ncbi.nlm.nih.gov/pubmed/36923718
http://dx.doi.org/10.1097/GOX.0000000000004881
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author Schwartz, Jean-Claude D.
author_facet Schwartz, Jean-Claude D.
author_sort Schwartz, Jean-Claude D.
collection PubMed
description Prepectoral implant-based breast reconstruction has become more common given the reduced dissection, decreased postoperative pain, elimination of animation deformity, and improved aesthetics compared with subpectoral reconstructions. Despite these benefits, surgeons must contend with increased rates of implant rippling and more tenuous implant positioning and coverage, especially in direct-to-implant reconstructions. Although the use of an acellular dermal matrix can assist with both implant rippling and support/positioning, it does not protect against implant exposure, and rippling can still occur, despite its use, with significant additional cost. This article looks into the use of a lateral adipodermal flap that assists with reducing the mismatch between the excess skin and implant surface area, implant positioning (by helping secure the lateral mammary fold), and providing implant coverage. Twenty-two patients underwent 38 nipple-sparing mastectomies and prepectoral direct-to-implant reconstructions using a lateral adipodermal flap without acellular dermal matrix. No patients had evidence of implant malposition or exposure with at least 6 months follow-up. The author concludes that the lateral adipodermal flap may be helpful in securing the lateral mammary fold, reducing excess skin and providing viable tissue coverage in patients undergoing prepectoral direct-to-implant reconstruction.
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spelling pubmed-100108492023-03-14 The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction Schwartz, Jean-Claude D. Plast Reconstr Surg Glob Open Breast Prepectoral implant-based breast reconstruction has become more common given the reduced dissection, decreased postoperative pain, elimination of animation deformity, and improved aesthetics compared with subpectoral reconstructions. Despite these benefits, surgeons must contend with increased rates of implant rippling and more tenuous implant positioning and coverage, especially in direct-to-implant reconstructions. Although the use of an acellular dermal matrix can assist with both implant rippling and support/positioning, it does not protect against implant exposure, and rippling can still occur, despite its use, with significant additional cost. This article looks into the use of a lateral adipodermal flap that assists with reducing the mismatch between the excess skin and implant surface area, implant positioning (by helping secure the lateral mammary fold), and providing implant coverage. Twenty-two patients underwent 38 nipple-sparing mastectomies and prepectoral direct-to-implant reconstructions using a lateral adipodermal flap without acellular dermal matrix. No patients had evidence of implant malposition or exposure with at least 6 months follow-up. The author concludes that the lateral adipodermal flap may be helpful in securing the lateral mammary fold, reducing excess skin and providing viable tissue coverage in patients undergoing prepectoral direct-to-implant reconstruction. Lippincott Williams & Wilkins 2023-03-13 /pmc/articles/PMC10010849/ /pubmed/36923718 http://dx.doi.org/10.1097/GOX.0000000000004881 Text en Copyright © 2023 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Breast
Schwartz, Jean-Claude D.
The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title_full The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title_fullStr The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title_full_unstemmed The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title_short The Utility of a Lateral Adipodermal Flap in Prepectoral Direct-to-implant Breast Reconstruction
title_sort utility of a lateral adipodermal flap in prepectoral direct-to-implant breast reconstruction
topic Breast
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010849/
https://www.ncbi.nlm.nih.gov/pubmed/36923718
http://dx.doi.org/10.1097/GOX.0000000000004881
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