Trial reportPlastic and reconstructive surgery2017
Direct-to-Implant versus Two-Stage Tissue Expander/Implant Reconstruction: 2-Year Risks and Patient-Reported Outcomes from a Prospective, Multicenter Study.
Trial report in Plastic and reconstructive surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 42 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 109 citations in OpenAlex.
- Bibliometric analysis of quality of life in implant-based breast reconstruction.Frontiers in oncology · 2024Pooled it
- First-year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study.Journal of surgical oncology · 2021Trial
- Beyond expansion: the strategic role of the tissue expander in immediate breast reconstruction.JPRAS open · 2026Review
- Immediate Implant-Based Breast Reconstruction: Analysis of 787 Cases and Definition of Our Decision-Making Algorithm.Aesthetic plastic surgery · 2026Article
- Battle of the Brands: A Multicenter Comparative Analysis of Outcomes in Immediate Implant-based Breast Reconstruction With Acellular Dermal Matrices.Plastic and reconstructive surgery. Global open · 2026Article
- Breast Reconstruction After Cancer: Historical Development, Modern Techniques, and Psychological Impact.Healthcare (Basel, Switzerland) · 2026Review
- Shifting Practice Patterns in Implant-based Breast Reconstruction in China: Insights From a 13-year Large-scale Retrospective Cohort.Plastic and reconstructive surgery. Global open · 2026Article
- Are thin flaps still a contraindication? Early outcomes of prepectoral DTI reconstruction in a large single-center cohort.Frontiers in oncology · 2026Article
- Dynamic Contour Irregularities in Implant-Based Breast Reconstruction: Long-Term Aesthetic Outcomes After Direct-to-Implant Versus Tissue Expander Techniques.Journal of clinical medicine · 2025Article
- Evaluation of Pre-Pectoral Direct-to-Implant Breast Reconstruction with Post-Mastectomy Radiation: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Two-stage Implant-based Breast Reconstruction Without the Use of Tissue Expanders.Plastic and reconstructive surgery. Global open · 2025Article
- Reconstructing Failure: Assessing Surgical and Patient-Reported Outcomes after Loss of Initial Breast Reconstruction.Plastic and reconstructive surgery · 2025Article
- Direct-to-Implant in the Era of Prepectoral Breast Reconstruction: Evaluation of the National Trend in 59,313 Patients.Plastic and reconstructive surgery. Global open · 2025Article
- Trends and Early Complications in Direct-to-Implant Breast Reconstruction: An Updated Analysis of the ACS-NSQIP Database.Plastic surgery (Oakville, Ont.) · 2024Article
- Marijuana's Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study.Plastic and reconstructive surgery. Global open · 2024Article
- Direct-to-Implant vs Tissue Expander Placement in Immediate Breast Reconstruction: A Prospective Cohort Study.Aesthetic surgery journal · 2024Article
- A prospective randomized clinical trial to assess antibiotic pocket irrigation on tissue expander breast reconstruction.Microbiology spectrum · 2023Article
- Article
- Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review.International journal of clinical oncology · 2023Article
- A descriptive comparison of satisfaction and well-being between expander-based and direct-to-implant breast reconstruction after Nipple-Sparing Mastectomy.Aesthetic plastic surgery · 2023Article
Corrections and comments
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDirect-to-implant breast reconstruction offers time-saving advantages over two-stage techniques. However, use of direct-to-implant reconstruction remains limited, in part, because of concerns over complication rates., The authors' aim was to compare 2-year complications and patient-reported outcomes for direct-to-implant versus tissue expander/implant reconstruction.
methodsPatients undergoing immediate direct-to-implant or tissue expander/implant reconstruction were enrolled in the Mastectomy Reconstruction Outcomes Consortium, an 11-center prospective cohort study. Complications and patient-reported outcomes (using the BREAST-Q questionnaire) were evaluated. Outcomes were compared using mixed-effects regression models, adjusting for demographic and clinical characteristics.
resultsOf 1427 patients, 99 underwent direct-to-implant reconstruction and 1328 underwent tissue expander/implant reconstruction. Two years after reconstruction and controlling for covariates, direct-to-implant and tissue expander/implant reconstruction patients did not show statistically significant differences in any complications, including infection. Multivariable analyses found no significant differences between the two groups in patient-reported outcomes, with the exception of sexual well-being, where direct-to-implant patients fared better than the tissue expander/implant cohort (p = 0.047).
conclusionsThis prospective, multi-institutional study showed no statistically significant differences between direct-to-implant and tissue expander/implant reconstruction, in either complication rates or most patient-reported outcomes at 2 years postoperatively. Direct-to-implant reconstruction appears to be a viable alternative to expander/implant reconstruction. This analysis provides new evidence on which to base reconstructive decisions. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.