ArticleHealthcare (Basel, Switzerland)2023
From Sub-Pectoral to Pre-Pectoral Implant Reconstruction: A Decisional Algorithm to Optimise Outcomes of Breast Replacement Surgery.
Article in Healthcare (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Application of Titanium-Coated Polypropylene Mesh (TiLOOP Bra) Combined with a De-Epithelialized Dermal Flap During Skin-Reducing Mastectomy (SRM) for Immediate Implant-Based Breast Reconstruction (IBR) in Chinese Patients.Aesthetic plastic surgery · 2026Article
- Management of Breast Cancer by Skin-Reducing Mastectomy and Immediate Breast Reconstruction by Prepectoral Implant Approach with Polypropylene Mesh for Patients with Large Breasts.Aesthetic plastic surgery · 2025Article
- Nipple-Sparing Skin-Reducing Mastectomy and Immediate Prepectoral Breast Reconstruction: A New Surgical Approach.Aesthetic surgery journal. Open forum · 2025Article
- Advantages and Disadvantages of Breast Augmentation: Surgical Techniques, Outcomes and Future Directions.Cureus · 2024Review
- Recurrent Breast Animation after Conversion from Dual Plane to Prepectoral Breast Implant Placement.Plastic and reconstructive surgery. Global open · 2023Article
- INVITED DISCUSSION ON: Prepectoral Versus Subpectoral Direct-to-Implant Breast Reconstruction: Evaluation of Patient's Quality of Life and Satisfaction with BREAST-Q.Aesthetic plastic surgery · 2023Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInnovations and advancements with implant-based breast reconstruction, such as the use of ADMs, fat grafting, NSMs, and better implants, have enabled surgeons to now place breast implants in the pre-pectoral space rather than under the pectoralis major muscle. Breast implant replacement surgery in post-mastectomy patients, with pocket conversion from retro-pectoral to pre-pectoral, is becoming increasingly common, in order to solve the drawbacks of retro-pectoral implant positioning (animation deformity, chronic pain, and poor implant positioning). MATERIALS AND
methodsA multicentric retrospective study was conducted, considering all patients previously submitted to implant-based post-mastectomy breast reconstruction who underwent a breast implant replacement with pocket conversion procedure at the University Hospital of Udine-Plastic and Reconstructive Surgery Department-and "Centro di Riferimento Oncologico" (C.R.O.) of Aviano, from January 2020 to September 2021. Patients were candidates for a breast implant replacement with pocket conversion procedure if they met the following inclusion criteria: they underwent a previous implant-based post-mastectomy breast reconstruction and developed animation deformity, chronic pain, severe capsular contracture, or implant malposition. Patient data included age, body mass index (BMI), comorbidities, smoking status, pre- or post-mastectomy radiotherapy (RT), tumour classification, type of mastectomy, previous or ancillary procedures (lipofilling), type and volume of implant used, type of ADM, and post-operative complications (breast infection, implant exposure and malposition, haematoma, or seroma).
resultsA total of 31 breasts (30 patients) were included in this analysis. Just three months after surgery, we recorded 100% resolution of the problems for which pocket conversion was indicated, which was confirmed at 6, 9, and 12 months post-operative. We also developed an algorithm describing the correct steps for successful breast-implant pocket conversion.
conclusionOur results, although only early experience, are very encouraging. We realized that, besides gentle surgical handling, one of the most important factors in proper pocket conversion selection is an accurate pre-operative and intra-operative clinical evaluation of the tissue thickness in all breast quadrants.
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