Acellular Dermal Matrix without Basement Membrane in Immediate Prepectoral Breast Reconstruction: A Randomized Controlled Trial.

Background: Acellular dermal matrix (ADM) has become popular in various reconstructive procedures of different anatomic regions. There are different needs depending on the clinical application, including breast, abdominal wall, and any other soft-tissue reconstruction. Removal of the basement membrane, which consists of collagen fibers, may help achieve natural and soft breast reconstruction, which requires highly elastic ADMs.

Comparing outcomes of prepectoral, partial muscle-splitting subpectoral, and dual-plane subpectoral direct-to-implant reconstruction: implant upward migration and the pectoralis muscle.

Background: Although dual-plane subpectoral breast reconstruction has been widely implemented in implant-based breast reconstruction, animation deformities remain an issue. Recent advances in skin flap circulation detection have increased the use of prepectoral reconstruction. A partial muscle-splitting subpectoral plane was introduced to decrease the visibility of the implant edge.

Evaluation of safety and operative time in tumescent-free robotic nipple-sparing mastectomy: a retrospective single-center cohort study.

Purpose: Tumescent in nipple-sparing mastectomy (NSM) has been reported to increase the risk of necrosis by impairing blood flow to the skin flap and nipple-areolar complex. At our institution, we introduced a tumescent-free robotic NSM using the da Vinci single-port system (Intuitive Surgical, Inc.).

Analysis of flap thickness to breast projection ratio correlating to body mass index and age in east Asian women: Considerations in flap selection in breast reconstruction.

Background: Several alternative flaps have been introduced and used for autologous breast reconstruction. However, as body fat distribution is different among patients, the donor of choice for sufficient breast projection varies between patients.

Methods: Patients who underwent autologous breast reconstruction from Jan 2018 to Sep 2022 were included.

Human-Mimic Submuscular and Premuscular Irradiated Rat Model: Histologic Characteristics of the Capsule Tissue in Contact with the Breast Implant.

Background: In this study, we established two rat models that mimic human submuscular and premuscular breast reconstruction. We analyzed the capsule formation according to surgical techniques and adjacent tissues, including the chest wall tissues, such as the ribs and acellular dermal matrices (ADMs) that come in contact with silicone implants.

Methods: This study consisted of experiments on 12 Sprague-Dawley rats that underwent implant reconstruction using ADM.

Conventional versus Robot-Assisted Immediate Breast Reconstruction: Reconstructive Outcome and Patient-Reported Outcome Measures.

Background: In this study, the authors compared conventional and robot-assisted mastectomy and breast reconstruction. To the authors' knowledge, this study is the first to report the results of robot-assisted mastectomy and breast reconstruction and provide a comparison of patient-reported outcomes.

Method: This retrospective study included 473 breasts of 423 patients who underwent conventional mastectomy and breast reconstruction and 164 breasts of 153 patients who underwent robot-assisted mastectomy and breast reconstruction from July of 2019 to October of 2021.

A comparison of clinical outcomes of acellular dermal matrix with and without radiation sterilization process in immediate prepectoral direct-to-implant breast reconstruction.

Background: Although there are many acellular dermal matrix (ADM) products, the sterilization process varies for each product. We compared the clinical outcomes of immediate prepectoral direct-to-implant (DTI) breast reconstruction with and without sterilization products.

Methods: This was a retrospective study of immediate prepectoral DTI breast reconstructions performed between 2018 and 2020.

Safety of Augmenting Breast Volume in Direct-to-Implant Breast Reconstruction With Contralateral Breast Augmentation: Comparison With 2-Stage Reconstruction.

Background: Direct-to-implant breast reconstruction is a standard method of implant-based reconstruction; however, the risk of skin necrosis and implant failure exists. During simultaneous contralateral augmentation, an implant larger than the resected tissue must be inserted to balance both sides, which may increase the risk of complications. This study examined the differences in the incidence of complications between the single-stage direct-to-implant reconstruction and 2-stage reconstruction when contralateral augmentation was performed simultaneously.

Analysis on the Difference between the Practical Brassiere Size and Real Breast Volume.

Background: Brassiere cup size is defined as the difference in chest circumference between the inframammary fold and the fullest part of the breast. However, a large number of women are not aware of the correct definition and are prone to wearing incorrectly-sized brassieres. In this report, the authors compared the cup size of worn brassieres and the actual measurement.

The effect of intraoperative immersion solutions on acellular dermal matrix: Biofilm formation and mechanical property.

Background: Acellular dermal matrix (ADM) is generally used on implant-based breast operations; However, it can increase surgical site infection. Many immersion solutions are applied to ADM, however, the most effective solution is unknown. The purpose of this study is to determine the effect of different solutions on the biofilm formation and mechanical properties of ADM.

Magnetic Resonance Imaging Surveillance Study of Silicone Implant-based Breast Reconstruction: A Retrospective Observational Study.

Unlabelled: This study aimed to evaluate the results of magnetic resonance imaging (MRI) surveillance of implant-based breast reconstruction in patients with breast cancer.

Methods: This retrospective observational study analyzed patients who underwent implant-based breast reconstruction and MRI surveillance by a single surgeon from March 2011 to December 2018, in a single center. All patients were informed about the recommendation of the Food and Drug Administration for MRI surveillance, and they choose to undergo MRI 3 years after surgery.

Robot-Assisted Capsulectomy with Immediate Reimplantation in Breast Reconstruction.

Recent reports have introduced robotic breast surgery for immediate breast reconstruction with an implant. However, relevant reports of robot-assisted breast reconstruction including capsulectomy are limited. Although capsulectomy lowers risk of capsular contracture and thus contributes to better aesthetic outcomes, total capsulectomy may have complications, such as injury to axillary structures or chest wall and overlying skin devascularization.

Cadaveric Study for Safe Elevation of a Profunda Artery Perforator Flap: Anatomy of the Perforators and Obturator Nerves.

Background:  This cadaveric study aimed to describe the anatomy of the profunda artery perforators (PAPs).

Methods:  In total, nine free cadavers with 18 upper thighs were dissected, 12 of which were from female cadavers, and 6 were from male cadavers. The average age of the cadavers was 84.

Development of Three-Dimensional Breast Scan and Measurement Application Using Laser Imaging Detection and Ranging Sensor on iPhone.

Laser imaging detection and ranging (LiDAR) is a modern three-dimensional (3D) technology that uses a time-of-flight method based on the round-trip time of an infrared laser beam to detect the presence and features of objects. The iPhone 12 Pro is the first smart mobile device with built-in LiDAR sensors. The authors' team developed a software application based on iOS devices with built-in LiDAR sensors for 3D breast scanning and automatically analyzing the breast's geometric measurement.

Difference in the Occurrence of Capsular Contracture According to Tissue Characteristics in an Irradiated Rat Model.

Background: This study was performed to evaluate the hypothesis that capsule formation varies according to the radiation dose in muscle tissues; chest wall tissues, including the ribs; and acellular dermal matrices (ADM) that are in contact with the silicone implant.

Methods: In this study, 20 Sprague-Dawley rats underwent submuscular plane implant reconstruction using ADM. They were divided into four groups: an unradiated control group ( n = 5), nonfractionated radiation at a dose of 10 Gy ( n = 5), nonfractionated radiation at a dose of 20 Gy ( n = 5), and fractionated radiation at a dose of 35 Gy ( n = 5).

A Comparative Study of Wraparound versus Anterior Coverage Placement of Acellular Dermal Matrix in Prepectoral Breast Reconstruction.

Background: Prepectoral direct-to-implant insertion (DTI) with acellular dermal matrix (ADM) is the currently preferred operation for breast reconstruction. There are different placements of ADM, which are largely classified as wraparound placement or anterior coverage placement. Because there are limited data comparing these two placements, this study aimed to compare the outcomes of these two methods.

Comparative Study of DIEP and PAP Flaps in Breast Reconstruction: Reconstructive Outcomes and Fat Necrosis.

Background:  This study compared the reconstructive outcomes and fat necrosis of the profunda artery perforator (PAP) flap with those of the deep inferior epigastric perforator (DIEP) flap.

Methods:  Data on all DIEP and PAP flap breast reconstructions performed between 2018 and 2021 at Asan Medical Center were compared. The overall reconstructive outcomes and presence of fat necrosis were analyzed through ultrasound evaluation performed by a board-certified radiologist.

Analysis of Perfusion in the DIEP Flap: Role of the Location of the Perforator, Umbilicus, and Midline Crossing-Over Vessel.

Background: During breast reconstruction, predicting contralateral perfusion of the deep inferior epigastric artery perforator flap can help minimize tissue necrosis. This study aimed to quantify the area of contralateral perfusion and identify the factors affecting it.

Methods: A retrospective study was conducted on unilateral breast reconstructions with a single perforator-based deep inferior epigastric artery perforator flap, for the period of 2017 to 2019.

Outcomes of smooth round implant-based immediate breast reconstruction: Long-term follow-up results.

The issue of breast implant-associated anaplastic large cell lymphoma in 2019 has resulted in the discontinuation of textured breast implants and resumption in the use of smooth round implants. However, in the field of breast reconstruction, long-term follow-up data for direct-to-implant reconstruction using smooth round implants is insufficient. This retrospective study aimed to evaluate the long-term outcomes of breast reconstruction using smooth round implants.

Outcome Analysis Depending on the Different Types of Incision following Immediate Breast Reconstruction.

Background: Immediate breast reconstruction following nipple-sparing mastectomy (NSM) is widely used for its cosmetic benefits. Due to the lack of guidelines, the types of incisions in NSM vary and which method is superior remains a debate. In this study, we hypothesized that the periareolar incision has a higher risk of complications, such as nipple-areolar complex (NAC) necrosis, than other incisions.

Intramuscular Deep Inferior Epigastric Vessels Are Insulated by Perimysial Fibroadipose Tissue Network.

Background:  The difficulty of elevating a deep inferior epigastric perforator (DIEP) flap largely depends on the intramuscular course of the vessel and the perforator. Previous studies, however, have lacked histologic descriptions of the vessels and surrounding structures. The present study analyzed the histologic aspects of the deep inferior epigastric vessels and perforators, focusing on their perivascular relationships with muscle fibers.

The Influence of Flow Velocity in the Feeding Vessel on Flap Perfusion in Deep Inferior Epigastric Artery Perforator Flap.

Background:  Contralateral perfusion of zones II and IV is critical to estimate the amount of fat necrosis and determine intraoperative flap sacrifice during autologous breast reconstruction. We aimed to determine whether perfusion of the contralateral side was affected by the peak flow velocity in the feeding vessels in the deep inferior epigastric artery (DIEA) perforator free flap reconstructions.

Methods:  This was a retrospective review of patients who received DIEA perforator flap for autologous breast reconstruction from February to July 2020.