ArticleGland surgery2025
Prepectoral breast reconstruction with and without acellular dermal matrix: a systematic review and meta-analysis.
Article in Gland surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Peri-areolar dermal reinforcement to prevent prosthetic-related complications in prepectoral reconstruction with a compromised nipple-areola complex: a surgical technique.Gland surgery · 2026Article
- Changing Paradigms in Polyurethane-coated Breast Implant Surgery: A Bibliometric Analysis of 4 Decades of Clinical Practice.Plastic and reconstructive surgery. Global open · 2026Article
- Breast Implants: Biomaterials, Surfaces, Biocompatibility-A Biomedical Engineering Perspective.Journal of clinical medicine · 2026Review
- Breast Reconstruction After Cancer: Historical Development, Modern Techniques, and Psychological Impact.Healthcare (Basel, Switzerland) · 2026Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The use of acellular dermal matrix (ADM) in prepectoral implant-based breast reconstruction has become increasingly widespread, aiming to enhance prosthetic support, reduce capsular contracture, and improve aesthetic outcomes. However, ADM remains a subject of debate due to its elevated cost and concerns regarding surgical morbidity. Current evidence is largely derived from retrospective, non-randomized studies, which limits the overall strength of available data. This study aims to clarify its clinical utility by conducting a meta-analysis of postoperative complications and a systematic review. Methods: A systematic review was conducted according to PRISMA guidelines, including observational studies comparing outcomes of prepectoral reconstruction with and without ADM. Postoperative complications were analyzed using risk ratios (RRs) with 95% confidence intervals (CIs). A random-effects model was used for outcomes with substantial heterogeneity (I Results: Nine studies involving 1,455 patients met inclusion criteria. No statistically significant differences were found in most complications: reoperation (RR: 1.02; 95% CI: 0.52-1.98; P=0.91), capsular contracture (RR: 0.72; 95% CI: 0.19-2.75; P=0.49), dehiscence (RR: 0.97; 95% CI: 0.40-2.35; P=0.93), hematoma (RR: 0.98; 95% CI: 0.29-3.28; P=0.96), implant removal (RR: 0.74; 95% CI: 0.46-1.20; P=0.16), infection (RR: 0.73; 95% CI: 0.51-1.05; P=0.07), necrosis (RR: 1.27; 95% CI: 0.64-2.53; P=0.41), rippling (RR: 0.54; 95% CI: 0.01-37.58; P=0.59), and seroma (RR: 0.81; 95% CI: 0.65-1.02; P=0.07). However, a subgroup analysis by reconstructive technique revealed notably higher rates of seroma (14.04% Conclusions: Prepectoral reconstruction with and without ADM shows similar complication rates. While ADM may offer structural and aesthetic benefits in selected patients, it also increases costs and may carry added risk. Because all included studies were retrospective and non-randomized, the level of evidence remains limited. These findings highlight the need for future prospective randomized trials to better define the role of ADM in clinical practice.
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