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One-Stage Immediate Breast Reconstruction: A Concise Review

BACKGROUND: One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness. MATERIAL AND METHODS: We reviewed the available li...

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Autores principales: Bertozzi, Nicolò, Pesce, Marianna, Santi, Pierluigi, Raposio, Edoardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643043/
https://www.ncbi.nlm.nih.gov/pubmed/29098159
http://dx.doi.org/10.1155/2017/6486859
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author Bertozzi, Nicolò
Pesce, Marianna
Santi, Pierluigi
Raposio, Edoardo
author_facet Bertozzi, Nicolò
Pesce, Marianna
Santi, Pierluigi
Raposio, Edoardo
author_sort Bertozzi, Nicolò
collection PubMed
description BACKGROUND: One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness. MATERIAL AND METHODS: We reviewed the available literature on one-stage direct-to-implant IBR, with or without acellular dermal matrix (ADM), synthetic mesh, or autologous fat grafting. We analyzed the indications, preoperative work-up, surgical technique, postoperative care, outcomes, and complications. RESULTS: IBR is indicated for small-to-medium nonptotic breasts and contraindicated in patients who require or have undergone radiotherapy, due to unacceptably high complications rates. Only patients with thick, well-vascularized mastectomy flaps are IBR candidates. Expandable implants should be used for ptotic breasts, while anatomical shaped implants should be used to reconstruct small-to-medium nonptotic breasts. ADMs can be used to cover the implant during IBR and avoid muscle elevation, thereby minimizing postoperative pain. Flap necrosis, reoperation, and implant loss are more common with IBR than conventional two-staged reconstruction, but IBR has advantages such as lack of secondary surgery, faster recovery, and better quality of life. CONCLUSIONS: IBR has good outcomes and patient-satisfaction rates. With ADM use, a shift from conventional reconstruction to IBR has occurred. Drawbacks of IBR can be overcome by careful patient selection.
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spelling pubmed-56430432017-11-02 One-Stage Immediate Breast Reconstruction: A Concise Review Bertozzi, Nicolò Pesce, Marianna Santi, Pierluigi Raposio, Edoardo Biomed Res Int Review Article BACKGROUND: One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness. MATERIAL AND METHODS: We reviewed the available literature on one-stage direct-to-implant IBR, with or without acellular dermal matrix (ADM), synthetic mesh, or autologous fat grafting. We analyzed the indications, preoperative work-up, surgical technique, postoperative care, outcomes, and complications. RESULTS: IBR is indicated for small-to-medium nonptotic breasts and contraindicated in patients who require or have undergone radiotherapy, due to unacceptably high complications rates. Only patients with thick, well-vascularized mastectomy flaps are IBR candidates. Expandable implants should be used for ptotic breasts, while anatomical shaped implants should be used to reconstruct small-to-medium nonptotic breasts. ADMs can be used to cover the implant during IBR and avoid muscle elevation, thereby minimizing postoperative pain. Flap necrosis, reoperation, and implant loss are more common with IBR than conventional two-staged reconstruction, but IBR has advantages such as lack of secondary surgery, faster recovery, and better quality of life. CONCLUSIONS: IBR has good outcomes and patient-satisfaction rates. With ADM use, a shift from conventional reconstruction to IBR has occurred. Drawbacks of IBR can be overcome by careful patient selection. Hindawi 2017 2017-10-02 /pmc/articles/PMC5643043/ /pubmed/29098159 http://dx.doi.org/10.1155/2017/6486859 Text en Copyright © 2017 Nicolò Bertozzi et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Bertozzi, Nicolò
Pesce, Marianna
Santi, Pierluigi
Raposio, Edoardo
One-Stage Immediate Breast Reconstruction: A Concise Review
title One-Stage Immediate Breast Reconstruction: A Concise Review
title_full One-Stage Immediate Breast Reconstruction: A Concise Review
title_fullStr One-Stage Immediate Breast Reconstruction: A Concise Review
title_full_unstemmed One-Stage Immediate Breast Reconstruction: A Concise Review
title_short One-Stage Immediate Breast Reconstruction: A Concise Review
title_sort one-stage immediate breast reconstruction: a concise review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643043/
https://www.ncbi.nlm.nih.gov/pubmed/29098159
http://dx.doi.org/10.1155/2017/6486859
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