title: Revisiting an Old Place: Single-Surgeon Experience on Post-Mastectomy Subcutaneous Implant-Based Breast Reconstruction.
abstract: Significant advances have been made to the reconstructive tools available to plastic surgeons allowing for the re-exploration of subcutaneous breast reconstruction. The purpose of the current study is to examine the safety, efficacy, and aesthetic results of subcutaneous breast reconstruction by a single-surgeon. A retrospective chart review was performed on all patients undergoing subcutaneous implant-based breast reconstruction between April 2012 and September 2014. All implants were fully wrapped in Alloderm and placed in the subcutaneous (pre-pectoral) plane. Primary outcome was a successful subcutaneous breast reconstruction. All complications were recorded. Aesthetics of the preoperative and postoperative photographs were examined. A total of 135 breasts (79 patients) were reconstructed. Direct-to-implant reconstruction was performed in 8 patients (10%). Successful breast reconstruction was achieved for 130 breasts in 76 patients (96%). Sixty-nine patients (87%) had a course free of any unexpected event or complication. There were no patients with implant extrusion or skin necrosis requiring operative intervention. When comparing pre-mastectomy breasts with post-mastectomy reconstructions, there was an improvement in the overall aesthetic outcome. Subcutaneous post-mastectomy breast reconstruction is safe and effective with comparable complication rates to standard techniques. Yet, this minimally invasive approach does not sacrifice the aesthetic results. Long-term studies will be required to prove the durability of aesthetic results overtime.
authors.affiliation: Department of Surgery Plastic, Surgery Mayo Clinic, Rochester, New York.
authors.forename: Alice
authors.identifier: http://orcid.org/0000-0001-7383-9948
authors.initials: A
authors.lastname: Woo
authors.affiliation: Department of Surgery Plastic, Surgery Mayo Clinic, Rochester, New York.
authors.forename: Christin
authors.initials: C
authors.lastname: Harless
authors.affiliation: Department of Surgery Plastic, Surgery Mayo Clinic, Rochester, New York.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty; D015414:Mastectomy, Subcutaneous; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: breast implants; breast reconstruction; subcutaneous breast reconstruction