Summary
Purpose
The use of acellular dermal matrix changed the breast reconstruction algorithm facilitating
implant coverage and direct to implant technique. This study aims to evaluate the
effect of the ADM surgical complications, breast aesthetics, and patient satisfaction.
Methods
In a tertiary hospital, patients that underwent implant-based breast reconstructions
during a three-year period had their charts retrospectively reviewed, received post-operative
BreastQ, and had their post-operative photos evaluated by a three-member panel using
a multi-parameter breast specific scale (scored 1–5). The complication information
was analysed per reconstructed breast while the analysis of aesthetic and patient-reported
outcomes was done per patient.
Results
A total of 501 patients (990 breasts) were evaluated. In the complication analysis
group, 20.3% of the breasts had ADM. Overall complications and major complications
were more frequent in the ADM group. During the first 30 postoperative days the most
frequent complications were: skin necrosis/delayed wound healing and haematoma, after
30 days was infection, and complications after 1 year being less than 1%.
On the outcome analysis group, ADM was used in 21.5% patients, 44% had post-operative
photos, and 29% answered the BreastQ. Factors associated with higher appearance score
were bilateral reconstruction, prophylactic surgery, and nipple presence. ADM demonstrated
no difference in satisfaction with breasts.
Conclusion
In implant-based breast reconstructions ADM has been shown to increase rate of complications.
The use of acellular dermal matrix did not influence the overall appearance or the
patient-reported outcome. A good aesthetic outcome is positively influenced by bilateral
reconstructions with preservation of the nipple.
Keywords
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Article info
Publication history
Published online: August 23, 2022
Accepted:
August 18,
2022
Received:
April 25,
2021
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
