Technical Results and Complication Rates after Nipple-Sparing Mastectomy and Direct-to-Implant Breast Reconstruction using Porcine Acellular Dermal Matrix for Implant Coverage

Einleitung/Zielsetzung:

To evaluate the feasibility and complication rates of nipple-sparing mastectomies (NSM) and direct-to-implant breast reconstruction using a porcine acellular dermal matrix (ADM) for implant coverage.

Material & Methoden:

NSM and direct-to-implant breast reconstruction using a porcine ADM for implant coverage was performed in a consecutive series of 110 breasts in 78 patients. Technical results, complications, and cosmetic results were collected from patient records.

Ergebnisse:

Short-term complications within one month comprised minor complications as minimal nipple necrosis in 10.9%, and infection in 0.9%. Major complications, as hemorrhage with surgical evacuation in 4.5%, and implant loss due to skin breakdown in 3.6%, totaled in 8.2%. Within three months after primary surgery 3 further severe complications with reoperation ocurred. In 89.1% no second surgical intervention was necessary and cosmetic results were good or excellent. After a mean follow-up of 24 months (range 2 – 46 months) no further complications could be observed. Patient satisfaction was high for 92.3% of the patients and subjective cosmetic result was excellent in 90.1% and satisfactory in 2.2%.

Zusammenfassung:

Direct-to-implant breast reconstruction using a porcine ADM for implant coverage after NSM is an innovative approach resulting in a high patient satisfaction. The technique is challenging but feasible and complication rates are acceptably low.