# A systematic review and meta−analysis on the prepectoral and partial subpectoral immediate single−stage Implant-Based Breast Reconstruction Using ADM

## TL;DR

This study compares two breast reconstruction methods using ADMs and finds that the prepectoral approach has fewer complications.

## Contribution

The study provides a meta-analysis comparing safety outcomes of prepectoral and partial subpectoral breast reconstruction techniques.

## Key findings

- Prepectoral reconstruction significantly reduced total complication rates compared to partial subpectoral reconstruction.
- Prepectoral reconstruction had lower rates of postoperative hematoma and skin–nipple necrosis.
- The findings suggest prepectoral reconstruction is safer for ADM-assisted breast reconstruction.

## Abstract

Acellular dermal matrices (ADMs) have made immediate single-stage prepectoral breast reconstruction (PBR) feasible and have promoted the application and development of partial subpectoral breast reconstruction (SBR). The type of mesh is regarded as a key factor influencing the safety of breast reconstruction. The optimal choice between prepectoral and partial subpectoral approaches for ADM-assisted immediate single-stage prosthetic breast reconstruction remains controversial. This study aimed to compare the safety profiles of these two surgical techniques.

A systematic literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library. All included patients underwent immediate single-stage implant-based breast reconstruction using ADM. Patient characteristics and postoperative complications were collected and summarized. Data analysis was performed using Cochrane RevMan and IBM SPSS software.

The meta-analysis incorporated 1,557 reconstructed breasts from eight eligible observational studies. Overall, PBR significantly reduced the total complication rate following immediate single-stage breast reconstruction compared with SBR. Additionally, PBR was associated with significantly lower rates of postoperative hematoma and skin–nipple necrosis compared with SBR.

The meta-analysis demonstrated that PBR was associated with lower safety risks for ADM-assisted immediate single-stage implant-based breast reconstruction.