ArticleAnnals of surgical oncology2021
A Critical Appraisal of Late Complications of Prepectoral versus Subpectoral Breast Reconstruction Following Nipple-Sparing Mastectomy.
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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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
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Comparative complications of prepectoral versus subpectoral breast reconstruction in patients with breast cancer: a meta-analysis.Frontiers in oncology · 2024Pooled it
- Effectiveness of Single vs Multiple Doses of Prophylactic Intravenous Antibiotics in Implant-Based Breast Reconstruction: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Practice patterns in prepectoral implant-based breast reconstruction: A survey of UK plastic surgeons.JPRAS open · 2026Article
- Trends in breast reconstruction for BRCA1/2, PALB2 and other high penetrance germline pathogenic variant carriers undergoing risk reducing mastectomy.Familial cancer · 2026Article
- Personalized Breast Reconstruction After Breast-Conserving Therapy: Risk-Informed Approaches to Technique Selection and Timing.Journal of personalized medicine · 2026Review
- Cumulative Medical Costs of Prepectoral Versus Subpectoral Implant-based Breast Reconstruction: A Single-Center Retrospective Analysis.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
- Selective Pectoralis Muscle Denervation Reduces Capsular Contracture in Sub-Pectoral Breast Reconstruction. Long-Term Retrospective Case- Control Study.ANZ journal of surgery · 2026Article
- Article
- Techniques for Success in Nipple-Sparing Mastectomy and Immediate Reconstruction.Journal of clinical medicine · 2025Review
- Nipple-Sparing Skin-Reducing Mastectomy and Immediate Prepectoral Breast Reconstruction: A New Surgical Approach.Aesthetic surgery journal. Open forum · 2025Article
- Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis.Plastic and reconstructive surgery. Global open · 2024Article
- Postoperative Outcomes of Pre-Pectoral Versus Sub-Pectoral Implant Immediate Breast Reconstruction.Cancers · 2024Article
- Surgical Decision Making in Genetically High-Risk Women: Quantifying Postoperative Complications and Long-Term Risks of Supplemental Surgery After Risk-Reducing Mastectomy.Annals of surgical oncology · 2024Article
- Technical consideration for breast reconstruction in patients requiring neoadjuvant or adjuvant radiotherapy: a narrative review.Annals of translational medicine · 2023Review
- Technical Tips to Reduce Implant Rippling in Staged Pre-pectoral Breast Reconstruction.Aesthetic plastic surgery · 2023Review
- Literature review and guide for optimal position in implant-based breast reconstruction.Gland surgery · 2023Review
- How Postoperative Infection Affects Reoperations after Implant-based Breast Reconstruction: A National Claims Analysis of Abandonment of Reconstruction.Plastic and reconstructive surgery. Global open · 2023Article
- Ptotic versus Nonptotic Breasts in Nipple-sparing Mastectomy and Immediate Prepectoral Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2023Article
- Correction of Rippling in Implant-based Breast Reconstruction with Serratus Fascia Flap.Plastic and reconstructive surgery. Global open · 2023Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNipple-sparing mastectomy (NSM) offers improved aesthetics without compromising oncologic safety. Subpectoral breast reconstruction has long been standard practice, although prepectoral reconstruction has recently resurged in popularity. Due to this recent paradigm shift, studies comparing long-term outcomes by reconstructive plane are lacking.
methodsA retrospective review was conducted on consecutive NSMs with implant-based reconstruction in either the prepectoral or subpectoral plane from 2014 to 2018. Patient demographics, implant specifications, and operative details were collected to evaluate primary outcomes of prosthetic failure and unplanned reoperations by reconstructive plane. Secondary outcomes included animation deformity, capsular contracture, rippling, plane change, and minor revisions, including fat grafting. Bivariate and multivariate analyses were performed to assess outcomes.
resultsOverall, 405 NSMs were performed on 228 women (subpectoral = 202, prepectoral = 203), with a mean follow-up of 2.1 years (standard deviation 1.1). During the study period (2014-2018), a shift from subpectoral to predominantly prepectoral mastectomies occurred in 2017. Prepectoral reconstructions were more often direct-to-implant (DTI) compared with subpectoral (73.9% vs. 33.2%, p < 0.001). Prepectoral reconstruction demonstrated significantly reduced prosthetic failure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.14-0.65) and unplanned reoperations (OR 0.43, 95% CI 0.24-0.77) compared with subpectoral reconstruction after controlling for implant characteristics and other possible confounders. Prepectoral patients experienced decreased animation deformity overall (19.7% vs. 0.0%, p < 0.001), with plane changes seen in 10.6% of subpectoral reconstructions for animation deformity correction. Prepectoral patients experienced an increase in rippling (15.3% vs. 6.1%, p = 0.003) without a significant increase in fat grafting (subpectoral = 11.6% vs. prepectoral = 12.3%, p = 0.829).
conclusionsThis single-institution experience compares late complications of prepectoral and subpectoral implant-based reconstruction following NSM. Prepectoral reconstruction can be safely performed with improved understanding of mastectomy planes, readily affords DTI reconstruction, and reduces animation deformity at the expense of rippling.
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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.