Journal of Universal Surgery

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Immediate Prosthetic Breast Reconstruction after Nipple-Sparing Mastectomy: Traditional Subpectoral Technique versus Direct-to-Implant Prepectoral Reconstruction without Acellular Dermal Matrix

6th International Conference on PLASTIC AND RECONSTRUCTIVE SURGERY
September 23, 2021 Webinar

Gianluca Franceschini

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome - Italy

Keynote: J Univer Surg


Background: The aim of this study was to compare outcomes of immediate prosthetic breast reconstruction (IPBR) using traditional submuscular (SM) positioning of implants versus prepectoral (PP) positioning of micropolyurethanefoam- coated implants (microthane) without further coverage. Methods: We retrospectively reviewed the medical records of breast cancer patients treated by nipple-sparing mastectomy (NSM) and IPBR in our institution during the two-year period from January 2018 to December 2019. Patients were divided into two groups based on the plane of implant placement: SM versus PP. Results: 177 patients who received IPBR after NSM were included in the study; implants were positioned in a SM plane in 95 patients and in a PP plane in 82 patients. The two cohorts were similar for mean age (44 years and 47 years in the SM and PP groups, respectively) and follow-up (20 months and 16 months, respectively). The mean operative time was 70 min shorter in the PP group. No signifi cant differences were observed in length of hospital stay or overall major complication rates. Statistically signifi cant advantages were observed in the PP group in terms of aesthetic results, chronic pain, shoulder dysfunction, and skin sensibility (p < 0.05), as well as a trend of better outcomes for sports activity and sexual/relationship life. Cost analysis revealed that PP-IPBR was also economically advantageous over SM-IPBR. Conclusions: Our preliminary experience seems to confi rm that PP positioning of a polyurethane-coated implant is a safe, reliable and effective method to perform IPBR after NSM.

Biography :

Gianluca Franceschini is Associate Professor of General Surgery – Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome - Italy since 1st January 2017. Member of “REPRISE” (Register of the Scientifi c Experts for Italian Ministry of Education – MIUR). Winner of the Editor’s Medal for best paper published in “Clinical Radiology” in 2010 ("Diffusion-weighted imaging in breast cancer: relationship between apparent diffusion coeffi cient and tumour aggressiveness" (Clinical Radiology. 65; 2010; 1005-1012), as coauthor. Founding Partner and Member of the non-profi t Organization, “Susan G. Komen Italia”, since February 2000. Permanent Member of the College of Italian Breast Surgeons since 15th February 2016. He is a guest editor for many international jounals.