Background: Acellular dermal matrix (ADM) in implant-based breast reconstruction can show various ultrasound (US) findings. However, there are limited reports on the US features of the ADM. The aims of this study were to evaluate US findings of the ADM in implant-based breast reconstruction and correlate them with histopathological findings.
Methods: Between January 2015 and August 2020, 250 women who underwent implant-based breast reconstruction with ADM and a breast US examination at 6 months to 1 year after reconstruction were retrospectively analyzed. Abnormal US findings were classified as type 1 (focal thickening with decreased echogenicity), 2 (diffusely hyperechoic), or 3 (bright echogenic spots). ADM biopsy was performed in 33 patients who underwent second stage or revisional surgeries.
Results: In total, 176 consecutive women with 207 US findings were analyzed. The US findings were normal in 52.2% of the women. The percentages of type 1, 2, and 3 patients were 13.5%, 11.1%, and 23. 2%, respectively. These patients had microscopic findings that showed patchy areas with chronic inflammatory infiltrates, dense collagen bundles without degenerative or inflammatory changes, and empty spaces or degenerated foci unaccompanied by inflammation.
Conclusion: Knowing the various ADM presentations on US can help avoid unnecessary invasive procedures.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877379 | PMC |
http://dx.doi.org/10.3390/jcm11041057 | DOI Listing |
Aesthetic Plast Surg
January 2025
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Background: In the realm of implant-based breast reconstruction, mastectomy flap necrosis (MFN) is a prevalent yet grave complication that poses a threat to the stability of the inserted prosthesis. Although numerous investigations have scrutinized the risk factors for MFN development, few have delved into the aftermath, specifically implant failure or salvage. This study seeks to appraise the prognosis of the implanted prosthesis following MFN occurrence, as well as identify predictors of such outcomes.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland.
: Combining autologous fat grafting with implant placement is meant to improve the quality of implant-based breast reconstruction. The present study explores the concept of multi-stage composite breast reconstruction with repeated sessions of autologous fat grafting to increase mastectomy flap thickness and provide better pre-pectoral implant coverage. : Twenty-five consecutive patients underwent bilateral multi-stage composite expander-to-implant breast reconstruction and reverse expansion from August 2020 to April 2024.
View Article and Find Full Text PDFAesthetic Plast Surg
January 2025
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
Background: In implant-based breast surgery, microbial contamination of implant surfaces predisposes complications such as overt periprosthetic infection and has been linked to capsular contracture (CC). Anti-microbial practices, including povidone-iodine (PVP-I) breast pocket irrigation, are routinely employed to minimise these risks. No standardised protocol for using this antiseptic exists, particularly concerning the ideal concentration.
View Article and Find Full Text PDFAnn Plast Surg
February 2025
Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA.
Background: Red breast syndrome (RBS) has been noted in past literature as a possible complication of implant-based breast reconstruction (IBBR) with the use of acellular dermal matrices (ADMs). Since its first appearance in 2009, RBS has drawn growing medical attention with reported incidence ranging from 7%-9%. There has been a noted decrease in the emergence of RBS despite its inclusion among the analyzed complications in a number of studies.
View Article and Find Full Text PDFFront Oncol
January 2025
Thyroid and Breast Medical Center, Weifang People's Hospital, Shandong Second Medical University, Weifang, Shandong, China.
Background: In recent years, different approaches to implant-based breast reconstruction have increasingly become an important option to meet both the treatment and postoperative aesthetic needs of breast cancer patients. This study selected two commonly used techniques for the prepectoral approach: single-incision, gas-inflated endoscopic prepectoral breast reconstruction (SIE-BR) and open prepectoral implant-based breast reconstruction (C-BR), as well as a commonly used technique for the subpectoral approach: open subpectoral implant-based breast reconstruction (SI-BR). By comparing the clinical efficacy and aesthetic outcomes of these three techniques in the treatment of breast cancer patients, this study aims to summarize the advantages of the prepectoral approach.
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