Benedetto Longo, Martina Giacalone, Gennaro D'Orsi, Alessio Farcomeni, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Claudio Oreste Buonomo, Valerio Cervelli
{"title":"立即混合乳房重建:双平面方法使用乳房前植入物和倒乳脂肪移植。","authors":"Benedetto Longo, Martina Giacalone, Gennaro D'Orsi, Alessio Farcomeni, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Claudio Oreste Buonomo, Valerio Cervelli","doi":"10.1097/PRS.0000000000011984","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Implant-based breast reconstruction (BR) is to date the most popular reconstructive modality. The aim of the study was to evaluate the immediate hybrid 1-stage BR technique, with a dual-plane approach, using prepectoral implants and retropectoral autologous fat transfer (AFT).</p><p><strong>Methods: </strong>The autthors prospectively enrolled patients scheduled for immediate BR using a hybrid approach, which included retropectoral AFT and prepectoral breast implants (group A). This cohort was compared with a retrospective control group of patients who underwent immediate direct-to-implant BR without AFT (group B). Complications, hospitalization days, number of AFT procedures for a complete BR, aesthetic outcomes, and patient satisfaction were analyzed. Fat suuvival rate was assessed through comparison of preoperative and 6-month postoperative MRI scans.</p><p><strong>Results: </strong>Thirty immediate BRs were included in each group. The average amount of AFT in the retropectoral plane was 106.30 cc (SD, 16.54), and the mean breast implant size was statistically higher in group B (P = 0.00026). MRI assessment confirmed an average of 47.90% (SD, 0.14%) retropectoral fat survival at 6 months postoperatively. No statistically significant differences in terms of complications and hospitalization days were observed (P > 0.05), whereas a significant difference was observed regarding additional AFT sessions (P = 0.00062). After a propensity score-weighted analysis, assessment by surgeons and patients showed a significantly higher overall satisfaction in the active group.</p><p><strong>Conclusion: </strong>The immediate hybrid approach for 1-stage BR enabled the use of smaller breast implants, allowed a decrease in AFT procedures with costs reduction, and yielded optimal breast shape and contour by reducing stepoff deformity and rippling alterations, without adding complications.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2","pages":"209-222"},"PeriodicalIF":3.4000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Immediate Hybrid Breast Reconstruction: Dual-Plane Approach Using Prepectoral Implants and Retropectoral Fat Grafting.\",\"authors\":\"Benedetto Longo, Martina Giacalone, Gennaro D'Orsi, Alessio Farcomeni, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Claudio Oreste Buonomo, Valerio Cervelli\",\"doi\":\"10.1097/PRS.0000000000011984\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Implant-based breast reconstruction (BR) is to date the most popular reconstructive modality. The aim of the study was to evaluate the immediate hybrid 1-stage BR technique, with a dual-plane approach, using prepectoral implants and retropectoral autologous fat transfer (AFT).</p><p><strong>Methods: </strong>The autthors prospectively enrolled patients scheduled for immediate BR using a hybrid approach, which included retropectoral AFT and prepectoral breast implants (group A). This cohort was compared with a retrospective control group of patients who underwent immediate direct-to-implant BR without AFT (group B). Complications, hospitalization days, number of AFT procedures for a complete BR, aesthetic outcomes, and patient satisfaction were analyzed. Fat suuvival rate was assessed through comparison of preoperative and 6-month postoperative MRI scans.</p><p><strong>Results: </strong>Thirty immediate BRs were included in each group. The average amount of AFT in the retropectoral plane was 106.30 cc (SD, 16.54), and the mean breast implant size was statistically higher in group B (P = 0.00026). MRI assessment confirmed an average of 47.90% (SD, 0.14%) retropectoral fat survival at 6 months postoperatively. No statistically significant differences in terms of complications and hospitalization days were observed (P > 0.05), whereas a significant difference was observed regarding additional AFT sessions (P = 0.00062). After a propensity score-weighted analysis, assessment by surgeons and patients showed a significantly higher overall satisfaction in the active group.</p><p><strong>Conclusion: </strong>The immediate hybrid approach for 1-stage BR enabled the use of smaller breast implants, allowed a decrease in AFT procedures with costs reduction, and yielded optimal breast shape and contour by reducing stepoff deformity and rippling alterations, without adding complications.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>\",\"PeriodicalId\":20128,\"journal\":{\"name\":\"Plastic and reconstructive surgery\",\"volume\":\"156 2\",\"pages\":\"209-222\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic and reconstructive surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PRS.0000000000011984\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and reconstructive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PRS.0000000000011984","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Immediate Hybrid Breast Reconstruction: Dual-Plane Approach Using Prepectoral Implants and Retropectoral Fat Grafting.
Background: Implant-based breast reconstruction (BR) is to date the most popular reconstructive modality. The aim of the study was to evaluate the immediate hybrid 1-stage BR technique, with a dual-plane approach, using prepectoral implants and retropectoral autologous fat transfer (AFT).
Methods: The autthors prospectively enrolled patients scheduled for immediate BR using a hybrid approach, which included retropectoral AFT and prepectoral breast implants (group A). This cohort was compared with a retrospective control group of patients who underwent immediate direct-to-implant BR without AFT (group B). Complications, hospitalization days, number of AFT procedures for a complete BR, aesthetic outcomes, and patient satisfaction were analyzed. Fat suuvival rate was assessed through comparison of preoperative and 6-month postoperative MRI scans.
Results: Thirty immediate BRs were included in each group. The average amount of AFT in the retropectoral plane was 106.30 cc (SD, 16.54), and the mean breast implant size was statistically higher in group B (P = 0.00026). MRI assessment confirmed an average of 47.90% (SD, 0.14%) retropectoral fat survival at 6 months postoperatively. No statistically significant differences in terms of complications and hospitalization days were observed (P > 0.05), whereas a significant difference was observed regarding additional AFT sessions (P = 0.00062). After a propensity score-weighted analysis, assessment by surgeons and patients showed a significantly higher overall satisfaction in the active group.
Conclusion: The immediate hybrid approach for 1-stage BR enabled the use of smaller breast implants, allowed a decrease in AFT procedures with costs reduction, and yielded optimal breast shape and contour by reducing stepoff deformity and rippling alterations, without adding complications.
Clinical question/level of evidence: Therapeutic, III.
期刊介绍:
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.