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J Plast Reconstr Aesthet Surg 2020 May 22. Epub 2020 May 22.

Plastic and Reconstructive Surgery Department, Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Anglia Ruskin School of Medicine, Anglia Ruskin University, Cambridge & Chelmsford, UK; Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Electronic address:

Plast Reconstr Surg 2020 May;145(5):917e-926e

Ann Arbor, Mich.; and Boston, Mass. From the Section of Plastic and Reconstructive Surgery, the Center for Statistical Consultation and Research, and the Department of Radiation Oncology, University of Michigan; and Plastic Surgery, Brigham and Women's Hospital.

Background: Whether to irradiate the tissue expander before implant exchange or to defer irradiation until after exchange in immediate, two-stage expander/implant reconstruction remains uncertain. The authors evaluated the effects of irradiation timing on complication rates and patient-reported outcomes in patients undergoing immediate expander/implant reconstruction.

Methods: Immediate expander/implant reconstruction patients undergoing postmastectomy radiation therapy at 11 Mastectomy Reconstruction Outcomes Consortium sites with demographic, clinical, and complication data were analyzed. Read More

Nagoya J Med Sci 2020 Feb;82(1):39-45

Department of Plastic and Reconstructive Surgery, Okayama University Hospital.

The popularity of a sling method using biomaterial sheets for immediate breast reconstruction based on prosthesis has been increasing in western countries. However, acellular dermal matrix, which is representative of the biomaterial sheet, is not available and the sling method also has not been accepted in Japan. We focused on a new bioabsorbable sheet (NEOVEIL sheet) as a substitute for the sling method and report a prospective study protocol to assess the safety and effectiveness of this material. Read More

Ann Plast Surg 2020 Apr 1. Epub 2020 Apr 1.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University Hospital.

Background: Hematomas after tissue expander immediate breast reconstruction (TE-IBR) pose a significant challenge during the recovery period. In this study, we aim to evaluate whether hematoma formation leads to subsequent complications and how management can impact final reconstructive goals.

Methods: A single-institution retrospective review of TE-IBRs from 2001 to 2018 was performed using an established breast reconstruction database. Read More

Plast Reconstr Surg 2020 Apr;145(4):865-876

Ann Arbor, Mich.; New York, N.Y.; Atlanta, Ga.; and Los Angeles, Calif. From the Section of Plastic Surgery, the School of Public Health, Center for Cancer Biostatistics, the Department of Radiation Oncology, Center for Bioethics and Social Science in Medicine, the Department of Internal Medicine, and the Department of Health Management and Policy, University of Michigan; Ann Arbor U.S. Department of Veterans Affairs Health Services Research and Development; the Department of Surgery, Memorial Sloan Kettering Cancer Center; the Department of Epidemiology, Emory University, Rollins School of Public Health; and the Department of Preventive Medicine, Keck School of Medicine, University of Southern California.

Background: Within the multidisciplinary management of breast cancer, variations exist in the reconstructive options offered and care provided. The authors evaluated plastic surgeon perspectives on important issues related to breast cancer management and reconstruction and provide some insight into factors that influence these perspectives.

Methods: Women diagnosed with early-stage breast cancer (stages 0 to II) between July of 2013 and September of 2014 were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries. Read More

Plast Reconstr Surg 2020 Jun;145(6):1357-1365

Loma Linda, Calif.; Winfield, Ill.; Portland, Ore; and Vancouver, Wash. From the Department of Plastic Surgery, Loma Linda University Medical Center; DuPage Medical Group/DMG Aesthetics; the Department of Plastic Surgery, Central DuPage Hospital/Northwestern Medicine; Compass Oncology; and Peacehealth Medical Group.

Background: Breast reconstruction in patients with a high body mass index (BMI) (≥30 kg/m) is technically challenging and is associated with increased postoperative complications. The optimal reconstructive approach for these patients remains to be determined. This study compared outcomes of prepectoral and dual-plane reconstruction in high-BMI patients to determine whether there was an association between postoperative complications and the plane of reconstruction. Read More

Arch Plast Surg 2020 Mar 27;47(2):140-145. Epub 2020 Feb 27.

Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Korea.

Background: Capsular contracture is a common complication of two-stage expander/implant breast reconstruction. To minimize the risk of this complication, capsulectomy is performed using monopolar cautery or ultrasonic surgical instrumentation, the latter of which can be conducted with a Harmonic scalpel. To date, there is disagreement regarding which of the two methods is superior. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2020 Feb;52(1):169-176

Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.

Objective: To investigate the outcomes of breast reconstruction with employing improved techniques throughout the tissue expander/implant two-stage breast reconstructed process, which involved the tissue expander placement, the saline filling intraoperatively and postoperatively, the implant selection, and the permanent implant replacement.

Methods: In this study, 68 patients who had been provided immediate or delayed tissue expander/implant two-stage breast reconstruction with autologous fat injection post-mastectomy in Peking University Third Hospital from April 2014 to September 2018 were involved, and the relevant information was analyzed retrospectively. The enhancements of the techniques, involving the incision selection, the expander placement, the principle of expansion, the management of capsule, the prosthesis selection, and the assisted reconstruction method were summarized, and the reconstruction outcomes were evaluated objectively through three-dimensional surface imaging. Read More

Plast Reconstr Surg 2020 Feb;145(2):421e-432e

Boston, Mass. From the Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School.

Learning Objectives: After reading this article, the participant should be able to: 1. Understand the indications for implant-based breast reconstruction and the indications for nipple preservation compared to skin-sparing or skin-reducing patterns. 2. Read More

Plast Reconstr Surg 2020 Feb;145(2):317-327

Milan, Italy From the Division of Radiation Oncology, Division of Epidemiology and Biostatistics, Unit of Medical Physics, Division of Plastic and Reconstructive Surgery, Division of Breast Surgery, and the Scientific Directorate, IEO, European Institute of Oncology IRCCS; and the Department of Oncology and Hemato-oncology, University of Milan.

Background: This study investigated the risk of reconstruction failure after mastectomy, immediate breast reconstruction, and radiotherapy to either a temporary tissue expander or permanent implant.

Methods: Records of women treated at a single institution between June of 1997 and December of 2011 were reviewed. Two patient groups were identified based on type of immediate breast reconstruction: tissue expander followed by exchange with a permanent implant and permanent implant. Read More

Plast Reconstr Surg 2020 Feb;145(2):240e-250e

Houston, Texas From the Division of Plastic Surgery, Baylor College of Medicine; and the Department of Plastic Surgery, Kelsey Seybold Clinic.

Background: Periprosthetic infections represent major complications in breast reconstruction, frequently leading to expander-implant loss. No consensus regarding a management algorithm for attempted salvage currently exists. This study assessed outcomes of the authors' salvage protocol using an antibiotic-impregnated polymethylmethacrylate implant with expander device exchange. Read More

Plast Reconstr Surg 2020 Jan 7. Epub 2020 Jan 7.

University of Michigan, Department of Radiation Oncology, Center for Bioethics and Social Science in Medicine.

Background: Within the multidisciplinary management of breast cancer, variations exist in the reconstructive options offered and care provided. This study aimed to evaluate plastic surgeon perspectives on important issues related to breast cancer management and reconstruction and provide some insight into factors that influence these perspectives.

Methods: Women diagnosed with early stage breast cancer (stages 0-II) between July 2013 and September 2014 were identified through the Georgia and Los Angeles SEER registries. Read More

Plast Reconstr Surg 2020 01;145(1):1e-8e

New Haven, Conn. From the Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine.

Background: The impact of insurance and socioeconomic status on breast reconstruction modalities when access to care is controlled is unknown.

Methods: Records for patients who underwent breast reconstruction at an academic medical center between 2013 and 2017 were reviewed and analyzed using chi-square analysis and logistic regression.

Results: One thousand six hundred eighty-three breast reconstructions were analyzed. Read More

Ann Plast Surg 2020 Jun;84(6):638-643

From the Department of Plastic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea.

Background: Complications after 2-stage tissue expander/implant breast reconstruction have been studied as outcomes of a single procedure. We separately evaluated complications after the second stage and assessed factors associated with the outcomes of the second stage of breast reconstruction.

Methods: Patients who underwent immediate 2-stage breast reconstruction between February 2010 and April 2017 were retrospectively reviewed. Read More

Plast Reconstr Surg 2019 12;144(6):1280-1290

New York, N.Y.; Hamilton, Ontario, Canada; Ann Arbor, Mich.; and Boston, Mass. From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; Division of Plastic Surgery, Department of Surgery, McMaster University; Section of Plastic Surgery, Department of Surgery, and Center for Statistical Consultation and Research, Department of Biostatistics, University of Michigan; and Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Harvard Medical School.

Background: Rates of breast reconstruction following mastectomy continue to increase. The objective of this study was to determine the frequency of elective revision surgery and the number of procedures required to achieve a stable breast reconstruction 2 years after mastectomy.

Methods: Women undergoing first-time breast reconstruction after mastectomy were enrolled and followed for 2 years, with completion of reconstruction occurring in 1996. Read More

Plast Reconstr Surg 2019 12;144(6):1270-1277

Rochester and Edina, Minn.; and Jeonju, South Korea From the Division of Plastic Surgery, the Division of Breast, Endocrine, Metabolic, and Gastrointestinal Surgery, Department of Surgery, the Division of Biomedical Statistics and Informatics, and the Division of Infectious Diseases, Department of Medicine, Mayo Clinic; Plastic Surgery Consultants; Jacobson Plastic Surgery; and Department of Plastic and Reconstructive Surgery, Jeonbuk National University Hospital.

Background: Surgical-site infection after implant-based breast reconstruction adversely affects surgical outcomes and increases health care costs. This 11-year case-control study examines risk factors specific for surgical-site infection after immediate tissue expander/implant-based breast reconstruction.

Methods: The authors performed a retrospective review to identify all consecutive patients with breast implant infections between 2006 and 2016. Read More

Plast Reconstr Surg 2019 12;144(6):960e-966e

Bronx, N.Y. From the Division of Plastic Surgery, Montefiore Medical Center.

Background: Patients undergoing autologous breast reconstruction have higher rates of patient-reported satisfaction compared to patients undergoing prosthetic reconstruction. Obesity has been shown to increase postoperative complications in both microsurgical and implant reconstructions. The authors evaluated the effects of microsurgical breast reconstruction and prosthetic breast reconstruction on patient-reported outcomes and quality of life in obese patients. Read More

J Surg Res 2020 03 20;247:156-162. Epub 2019 Nov 20.

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address:

Background: Mastectomy rates continue to increase in women diagnosed with breast cancer (BC). There are limited data regarding reconstruction rates at academic centers (AC) versus community hospitals (CH). We aim to determine the effect of facility type on reconstruction rates. Read More

Ann Surg 2019 Oct 23. Epub 2019 Oct 23.

Division of Plastic Surgery, Massachusetts General Hospital, Boston, MA.

Objectives: This study evaluates complications and reconstructive failure rates in implant-based reconstruction with radiotherapy.

Background: Postmastectomy radiotherapy may adversely affect breast reconstructive outcomes. However, the comparative effect of radiotherapy on direct-to-implant versus tissue expander-implant reconstruction has not been examined. Read More

Ann Plast Surg 2020 03;84(3):271-275

From the Division of Plastic Surgery, Department of Surgery.

Background: Implant-based breast reconstruction (IBR) accounts for 70% of postmastectomy reconstructions in the United States. Improving the quality of surgical care in IBR patients through accurate measurements of outcomes is necessary. The purpose of this study is to compare the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data from our institution to our complete institutional health records database. Read More

Aesthetic Plast Surg 2020 02 9;44(1):60-69. Epub 2019 Oct 9.

Department of General Surgery, Peking University Third Hospital, Beijing, China.

Background: In China, traditional preoperative planning of unilateral breast reconstruction mainly depends on anthropometric measurement and visual assessment. Thus, the lack of objective assessment of breast volume and shape would likely result in suboptimal reconstruction outcomes. Three-dimensional surface imaging (3D-SI), which could provide objective measurement data of the breast, may be a promising solution to this problem. Read More

Plast Reconstr Surg Glob Open 2019 Aug 8;7(8):e2355. Epub 2019 Aug 8.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, N.Y.

The use of acellular dermal matrices (ADMs) in breast reconstruction is a controversial topic. Recent literature has investigated the effects of ADM sterilization on infectious complications, although with varying conclusions. Previous work by our group showed no difference between aseptic and sterilized products immediately out of the package. Read More

J Plast Reconstr Aesthet Surg 2020 Feb 8;73(2):295-302. Epub 2019 Aug 8.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon, Gangnam, Seoul, Republic of Korea. Electronic address:

Background: Removal of the infected device has been the general treatment for device-associated infection in antibiotic failure. There have been anecdotal attempts to salvage infected medical devices by introducing a continuous closed irrigation system.

Objective: This study examines whether continuous closed irrigation of an infected device is a successful alternative to removal in patients with recalcitrant device-associated infection. Read More

Plast Reconstr Surg 2019 09;144(3):550-558

Loma Linda, Calif.; Winfield, Ill.; Portland, Ore.; and Vancouver, Wash. From the Department of Plastic Surgery, Loma Linda University Medical Center; DuPage Medical Group/DMG AESTHETICS; Departments of Plastic Surgery and Breast Surgery, Central DuPage Hospital/Northwestern Medicine; Breast Program, Compass Oncology; and Peacehealth Medical Group.

Background: Body mass index has been shown to be a predictor of outcomes after subpectoral expander/implant reconstruction, with every unit increase in body mass index increasing the risk of complications by approximately 6 percent. The effect of body mass index on complications after prepectoral reconstruction has not yet been evaluated and is the purpose of this study.

Methods: A total of 366 reconstructed breasts from 197 patients were stratified into five body mass index groups (normal; overweight; and class I, class II, and class III, obese) and postoperative complications were compared across the groups. Read More

Plast Reconstr Surg 2019 09;144(3):547-548

St. Louis, Mo. From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine.

Plast Reconstr Surg 2019 09;144(3):539-546

Milwaukee, Wis.; Murray, Utah; and Chicago, Ill. From the Department of Plastic Surgery, Medical College of Wisconsin; the Division of Plastic Surgery, Intermountain Healthcare; and the Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine.

Background: Obesity has reached epidemic proportions, with 72 million people in the United States classified as obese in 2010. This significant increase in obese patients is reflected in the breast cancer population seeking breast reconstruction. Previous studies demonstrated increased complication rates and decreased satisfaction in obese patients undergoing breast reconstruction. Read More

J Plast Reconstr Aesthet Surg 2019 Nov 27;72(11):1763-1768. Epub 2019 Jun 27.

Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 60, Opgang 94, Afsnit 41, 2100 Copenhagen, Denmark.

Background: Despite a trend towards immediate breast reconstruction in recent years, delayed breast reconstruction using a tissue expander remains a common procedure. Radiotherapy after mastectomy but before reconstruction is a risk factor, although studies examining the effect of this are limited. The aim of this retrospective cohort study is to evaluate the impact of pre-reconstructive radiotherapy (PRT) in patients undergoing breast reconstruction using an expander/implant. Read More

Ann Chir Plast Esthet 2019 Aug 19;64(4):285-292. Epub 2019 Jul 19.

Service de chirurgie plastique esthétique et reconstructrice, centre hospitalo-universitaire de Strasbourg, hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France. Electronic address:

Introduction: Breast implant-associated anaplastic large cell lymphoma is a recent pathology; the one known risk factor is breast implantation.

Methods: A retrospective study was conducted on the French BIA-ALCL cases diagnosed by the Lymphopath network and reported to the National Medical Safety Agency (ANSM). Wishing to obtain supplementary data on the prosthetic history of implants, we sent the referent surgeons a questionnaire. Read More

Contemp Oncol (Pozn) 2019 13;23(2):96-99. Epub 2019 Jun 13.

Department of Surgery, Rīga Stradiņš University, Riga, Latvia.

Introduction: Immediate breast reconstructions (IBR) have become an integral part of modern breast cancer management. However, in a small breast unit the spectrum of methods used for IBR could be limited, which could result in poorer results in some cases. The aim of the study is to evaluate the patient satisfaction and aesthetic outcome results in a breast unit where only implant-based IBR were performed. Read More

Breast J 2019 11 1;25(6):1071-1078. Epub 2019 Jul 1.

Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio.

Salvage mastectomy (SM) is the standard of care for patients with local recurrence (LR) after breast conservation therapy (BCT), often with immediate reconstruction. Complications of reconstruction are a concern for these patients, and long-term data are limited. We sought to compare rates of complications requiring re-operation (CRR) and reconstruction failure (RF) between autologous reconstruction (AR) and tissue expander/implant reconstruction (TE/I). Read More

Rom J Morphol Embryol 2019 ;60(1):87-93

Department of Plastic and Reconstructive Surgery, "Carol Davila" University of Medicine and Pharmacy, "Bagdasar-Arseni" Emergency Clinical Hospital, Bucharest, Romania;

The present paper describes and analyzes complications related to alloplastic breast reconstruction, as well as those associated with surgical techniques involving myocutaneous flaps. The article also contains a comparative analysis of the results obtained with the data in the international specialized literature. The statistical analysis is primary based on data obtained from patients included in the National Breast Reconstruction Program developed within the "Bagdasar-Arseni" Emergency Clinical Hospital, Bucharest, Romania, between 2015 and 2019. Read More

Pract Radiat Oncol 2019 Nov 22;9(6):e497-e505. Epub 2019 Jun 22.

Taussig Cancer Institute, Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.

Purpose: The toxicity profile of breast reconstruction with postmastectomy radiation therapy (PMRT) varies by technique and timing, and long-term data are limited. We compared rates of complications requiring reoperation (CRR) and reconstruction failure (RF) between immediate autologous reconstruction (I-AR), immediate tissue expander/implant reconstruction (I-TE/I), delayed autologous reconstruction (D-AR), and delayed tissue expander/implant reconstruction (D-TE/I) in patients receiving PMRT.

Methods And Materials: Patients who received autologous reconstruction (AR) or tissue expander/implant reconstruction (TE/I) and PMRT between 2000 to 2008 were included. Read More

Breast J 2019 09 11;25(5):1055-1056. Epub 2019 Jun 11.

Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, UK.

Medicina (Kaunas) 2019 May 29;55(6). Epub 2019 May 29.

Division of Plastic Surgery and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL 32224, USA.

: In those undergoing treatment for breast cancer, evidence has demonstrated a significant improvement in survival, and a reduction in the risk of local recurrence in patients who undergo postmastectomy radiation therapy (PMRT). There is uncertainty about the optimal timing of PMRT, whether it should be before or after tissue expander or permanent implant placement. This study aimed to summarize the data reported in the literature on the effect of the timing of PMRT, both preceding and following 2-stage expander-implant breast reconstruction (IBR), and to statistically analyze the impact of timing on infection rates and the need for explantation. Read More

Arch Gynecol Obstet 2019 08 29;300(2):409-420. Epub 2019 May 29.

Department of Gynecology, Red Cross Hospital Munich, Taxisstr. 3, 80637, Munich, Germany.

Objectives: The purpose of this study was to analyze the effects of prior radiotherapy (RT) as well as postmastectomy radiotherapy (PMRT) on patient-reported quality of life (QoL) and on surgical/aesthetic outcomes in patients with expander-/implant-based delayed immediate reconstruction (EIBR) compared to patients that underwent EIBR without any RT.

Material And Methods: QoL was assessed by BREAST-Q, the surgical/aesthetic outcome by a structured examination and a picture analysis (BCCT.CORE software) and subsequently compared between the three cohorts. Read More

Arch Plast Surg 2019 May 15;46(3):204-213. Epub 2019 May 15.

Department of Plastic and Reconstructive Surgery, Korea University College Medicine, Seoul, Korea.

Background: In implant-based breast reconstruction, acellular dermal matrix (ADM) is essential for supporting the inferolateral pole. Recent studies have compared non-sterilized freeze-dried ADM and sterilized pre-hydrated ADM, but have not assessed whether differences were attributable to factors related to sterile processing or packaging. This study was conducted to compare the clinical outcomes of breast reconstruction using two types of sterile-processed ADMs. Read More

Breast J 2019 07 11;25(4):757-759. Epub 2019 May 11.

Division of Plastic and Reconstructive Surgery, School of Medicine, University of Utah, Salt Lake City, Utah.

Int J Radiat Oncol Biol Phys 2019 09 2;105(1):155-164. Epub 2019 May 2.

Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Purpose: Giving an additional radiation dose to the incision or chest wall has been a practice, but it has never been studied in a randomized setting, and it might lead to inferior cosmetic outcomes. This study aims to evaluate whether delivery of a chest wall boost (CWB) to the mastectomy scar or chest wall is independently associated with reconstruction complications and to assess its disease control efficacy in the setting of breast reconstruction.

Methods And Materials: We conducted a retrospective chart review of 746 patients with breast cancer who underwent mastectomy, breast reconstruction, and PMRT; all underwent treatment at our institution during 1997 to 2016. Read More

Aesthet Surg J 2020 Mar;40(4):369-379

Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, CA.

Background: Breast capsular contracture is a major problem following implant-based breast reconstruction, particularly in the setting of radiation therapy. Recent work has identified a fibrogenic fibroblast subpopulation characterized by CD26 surface marker expression.

Objectives: This work aimed to investigate the role of CD26-positive fibroblasts in the formation of breast implant capsules following radiation therapy. Read More

J Plast Reconstr Aesthet Surg 2019 Jul 12;72(7):1067-1074. Epub 2019 Mar 12.

Plastic Surgery Department, A.C. Camargo Cancer Center, Rua Bartolomeu de Gusmão 200 Ap 201B, 04111 020 São Paulo, Brazil. Electronic address:

Background: Breast reconstruction with a latissimus dorsi myocutaneous flap associated with a breast implant is a well-established procedure. However, there are few published articles regarding latissimus association with expanders and radiotherapy. This study assess data of breast reconstructions using a latissimus dorsi myocutaneous flap associated with Becker expander implant (TLDMF/E) in patients submitted to radiotherapy. Read More

Plast Reconstr Surg Glob Open 2018 Nov 5;6(11):e1977. Epub 2018 Nov 5.

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.

Background: Traditionally, breast reconstruction options after mastectomy comprise an autologous flap or staged expander/implant reconstruction, or a combination of both. Recent introduction of skin or nipple-sparing mastectomies have led to much interest in direct-to-implant immediate breast reconstructions. We performed a retrospective review of our initial experience. Read More

Gland Surg 2019 Feb;8(1):67-74

Scottsdale Center for Plastic Surgery, Scottsdale, AZ, USA.

Background: Prosthetic breast reconstruction in the setting of post-mastectomy radiation therapy (PMRT) has historically been plagued by complications and poor outcomes. We study the effects of PMRT in the setting of prepectoral prosthetic breast reconstruction in an attempt to ascertain the value of this muscle sparing technique as it relates to complications and outcomes.

Methods: A retrospective analysis was performed on patients who underwent immediate, prepectoral, direct-to-implant or two-staged expander/implant breast reconstruction following skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) and had postmastectomy radiotherapy. Read More

Br J Surg 2019 04 5;106(5):586-595. Epub 2019 Mar 5.

Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, the Netherlands.

Background: Implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure and its economic impact is significant. This study aimed to analyse whether a direct one-stage IBBR with use of an acellular dermal matrix (ADM) is more cost-effective than two-stage (expander-implant) breast reconstruction.

Methods: The BRIOS (Breast Reconstruction In One Stage) study was an open-label multicentre RCT in which women scheduled for skin-sparing mastectomy and immediate IBBR were randomized between one-stage IBBR with ADM or two-stage IBBR. Read More

Aesthetic Plast Surg 2019 04 11;43(2):313-327. Epub 2019 Feb 11.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

Background: Major surgical concerns associated with nipple-sparing mastectomy (NSM) are partial or total nipple-areola complex (NAC) loss, decreased sensation, and nipple malposition. Patient satisfaction and NAC outcomes including malposition in patients who have undergone unilateral expander-implant reconstruction after NSM as compared with skin-sparing mastectomy (SSM) remain unclear. Therefore, the aim of this study was to assess patient satisfaction and NAC outcomes of breast cancer patients who underwent spared or reconstructed NAC after unilateral NSM as compared with unilateral SSM. Read More

Plast Reconstr Surg Glob Open 2018 Dec 17;6(12):e2046. Epub 2018 Dec 17.

Division of Plastic and Reconstructive Surgery, Stanford University Medical Center Palo Alto, Calif.

Background: Implant-based breast reconstruction is the most common reconstructive modality in the United States. Significant advances in surgical technique and technology have resulted in improvement of clinical outcomes. A recent innovation has been the introduction of a tissue expander with an integral drain that permits access to the periprosthetic space. Read More

Ann Chir Plast Esthet 2019 Jun 28;64(3):217-223. Epub 2018 Dec 28.

Service de chirurgie plastique, hôpital Civil Strasbourg, 1, place de l'hôpital, 67091 Strasbourg, France.

Introduction: The purpose of this study is to evaluate patients' satisfaction after immediate breast reconstruction (IBR) according to the surgical technique.

Methods: Included patients had an IBR between 2012 and 2017 and finished their reconstruction since a year. Patients were contacted by phone and their satisfaction was evaluated with the Breast Q questionnaire. Read More

Arch Plast Surg 2018 Nov 15;45(6):542-549. Epub 2018 Nov 15.

Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

Background: Despite the increasing popularity of prosthetic breast reconstruction, scant data exist on the microbiological profile of drainage fluid from closed-suction drains and the relationship thereof to surgical-site infections (SSIs) in breast reconstruction surgery. This study aimed to determine whether bacteria isolated from drainage fluid were associated with the development of SSIs, and whether the bacterial profile of drainage fluid could be a clinically useful predictor of SSIs.

Methods: We performed a retrospective chart review of 61 women who underwent tissue expander/implant or direct-to-implant reconstructions. Read More

J Plast Reconstr Aesthet Surg 2018 Dec 6;71(12):1761-1767. Epub 2018 Aug 6.

Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul, Korea. Electronic address:

Background: The aim of this study was to evaluate the impact of breast reconstruction modality on the incidence of shoulder morbidity.

Methods: Breast cancer patients who underwent immediate reconstructions using three modalities, namely, tissue expander-implant, latissimus dorsi (LD) pedicled flap, and deep inferior epigastric artery perforator (DIEP) flap, from 2008 to 2013 were examined. The cumulative incidence of shoulder morbidity was compared among the reconstruction modalities, and risk factor analysis was performed using multivariable analysis. Read More

Cancer Control 2018 Jan-Dec;25(1):1073274818795489

2 Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.

Purpose: The optimal approach to the integration of postmastectomy reconstruction and radiation therapy is not well-established. This review will summarize current literature pertaining to the most common types of reconstruction in the setting of postmastectomy radiation therapy (PMRT).

Data Sources: Literature from PubMed was reviewed from 2000 to 2016. Read More

J Plast Reconstr Aesthet Surg 2018 11 6;71(11):1547-1556. Epub 2018 Jul 6.

Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine. 601 N. Caroline St. Baltimore, MD USA. Electronic address:

Background: Human acellular dermal matrix (HADM) is an increasingly used adjunct to breast reconstruction. Previous meta-analyses demonstrate increased risks of complications, but these studies largely represent one product. The purpose of this study is to stratify outcomes on the basis of a meta-analysis of complications incorporating all new studies after 2012 and their associated new human-based products. Read More