title: Evaluation of a novel breast reconstruction technique using the Braxon®acellular dermal matrix: a new muscle-sparing breast reconstruction.
abstract: BACKGROUND
  Implant-based breast reconstruction is becoming increasingly popular because of the widespread adoption of acellular dermal matrix (ADM), which allows surgeons to obtain good aesthetic results with fewer operations. To develop more conservative surgical techniques, a retrospective, three-centre, proof-of-concept study was performed to study the effectiveness of a new, immediate, muscle-sparing breast reconstruction technique using the patented Braxon®ADM, which enables subcutaneous positioning of the breast implant without detaching the pectoralis major.
  
  
  METHODS
  Ethics committee of the study coordinating centre approved medical record review on 19 women who underwent muscle-sparing breast reconstruction between November 2012 and January 2014. The first 10 implants were performed using 0.9-mm-thick porcine ADM, with preservatives. In the subsequent 15 implants, the product was changed to 0.6-mm-thick porcine dry ADM, without preservatives.
  
  
  RESULTS
  Nineteen patients (25 implants) received six bilateral and 13 unilateral muscle-sparing breast reconstructions. For the first type of ADM used (0.9-mm-thick with preservatives), the rate of implant loss was 12% (n = 3) because of seroma (8%, n = 2) and infection (4%, n = 1). Minor complications, such as seroma (8%, n = 2), occurred when using the 0.6-mm-thick Braxon®ADM and were treated by aspiration. Symmetrical and natural breasts with good shape, ptosis and softness to the touch were obtained. None of the patients reported experiencing pain.
  
  
  CONCLUSIONS
  The preliminary results are encouraging from aesthetic and clinical viewpoints. Further studies are planned to evaluate long-term results.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ulss 9 General Hospital, Treviso, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Berna
authors.affiliation: Breast Care Center, North Bristol NHS Trust, Bristol, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Cawthorn
authors.affiliation: Breast Care Center, Ulss 12 General Hospital, Mestre, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Papaccio
authors.affiliation: Breast Care Center, Ulss 9 General Hospital, Treviso, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balestrieri
mesh_terms: D062088:Acellular Dermis / Q000592:standards*; D000818:Animals; D019928:Breast Implantation / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D018427:Breast Implants / Q000706:statistics & numerical data* / Q000662:veterinary; D003357:Cosmetic Techniques / Q000592:standards; D004954:Esthetics / Q000523:psychology; D005260:Female; D006801:Humans; D057910:Implant Capsular Contracture / Q000150:complications; D015994:Incidence; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010369:Pectoralis Muscles / Q000601:surgery*; D012189:Retrospective Studies; D049291:Seroma / Q000150:complications; D013552:Swine
keywords: ADM; Braxon; breast reconstruction; muscle-sparing; pectoralis major