ArticleAesthetic surgery journal2024
Direct-to-Implant vs Tissue Expander Placement in Immediate Breast Reconstruction: A Prospective Cohort Study.
Article in Aesthetic surgery journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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
12 citing papers in PubMed.
- Antibiotics and Surgical Site Infection in Expander-Based Breast Reconstruction Trial (ASSERT).Annals of surgical oncology · 2026Trial
- Beyond expansion: the strategic role of the tissue expander in immediate breast reconstruction.JPRAS open · 2026Review
- Comparison of different implant-based breast reconstruction strategies: A systematic review and Bayesian network meta-analysis.International journal of surgery (London, England) · 2026Article
- Invited Editorial: Antibiotics and Surgical Site Infection in Expander-Based Breast Reconstruction Trial (ASSERT).Annals of surgical oncology · 2026Article
- 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
- Does Breast Implant Size Larger Than Mastectomy Specimen Size Increase the Risk of Flap Necrosis?Aesthetic surgery journal. Open forum · 2026Article
- Beauty Under Pressure: The Impact of Hypertension on Outcomes in 54,000 Cases of Esthetic Breast Surgery.Aesthetic plastic surgery · 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
- Nipple-Sparing Mastectomy and Infection Risk after Immediate Breast Reconstruction.Journal of the American College of Surgeons · 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
- Tissue expander breast reconstruction outcomes following postmastectomy radiation therapy in the era of neoadjuvant chemotherapy.Frontiers in oncology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundDirect-to-implant (DTI) breast reconstruction after mastectomy has gained increasing popularity. While concerns over ischemic complications related to tension on the mastectomy flap persist, newer techniques and technologies have enhanced safety of this technique.
objectivesTo compare clinical and patient-reported outcomes of DTI and 2-stage tissue expander (TE) reconstruction.
methodsA prospective cohort design was utilized to compare the incidence of reconstructive failure among patients undergoing DTI and TE reconstruction by unadjusted bivariate and adjusted multivariable logistic regression analyses. Secondary clinical outcomes of interest included specific complications requiring intervention (infection, seroma, hematoma, mastectomy flap necrosis, incisional dehiscence, device exposure) and time to final drain removal. Patient-reported outcomes on BREAST-Q were also compared.
resultsA total of 134 patients (257 breasts) underwent DTI reconstruction and 222 patients (405 breasts) received TEs. DTI patients were significantly younger with lower BMIs; less diabetes, hypertension, and smoking; and smaller breast sizes; they also underwent more nipple-sparing mastectomies with prepectoral reconstructions. Rates of any complication (18% DTI vs 24% TE, P = .047), reconstructive failure (5.1% vs 12%, P = .004), and seroma (3.9% vs 11%, P < .001) were significantly lower in the DTI cohort on unadjusted analyses; however, there were no significant differences on adjusted regressions. Patient-reported satisfaction with breasts, psychosocial well-being, and sexual well-being were more substantively improved with DTI reconstruction.
conclusionsPrepectoral DTI reconstruction is a viable option for postmastectomy reconstruction in carefully selected patients, with no significant increase in reconstructive failure or other complications. LEVEL OF EVIDENCE: 2:
Indexed as
Identifiers
What OpenQuestion holds
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.