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      171. Assessing Long Term Outcomes In Prepectoral Versus Subpectoral Alloplastic Breast Reconstruction

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          Abstract

          PURPOSE: Tissue expanders (TEs) and implants can be placed using a subpectoral or prepectoral approach. At this time, long term data is needed to more effectively interpret the differences in clinical and patient reported outcomes (PROs) between prepectoral and subpectoral reconstruction. METHODS: We retrospectively reviewed female patients who underwent TE exchange to implants from 2017 to 2020. Patients had subpectoral or prepectoral reconstruction, along with preoperative and/or 1-2-year postoperative BREAST-Q data. We assessed PROs and complication rates with null hypothesis testing (significant: p<0.05). RESULTS: 2116 patients were included: 1797 subpectoral and 319 prepectoral. Regarding BREAST-Q scores, prepectoral patients had significantly higher scores than subpectoral patients for physical well-being of the chest preoperatively (p<0.001) and at 1-2-years postoperatively (p=0.003) and for satisfaction with breasts scores at 1-2-years postoperatively. Complications were low overall, but patients with prepectoral devices were more likely to get an infection, seroma, or wound dehiscence (p<0.001, p<0.001, p=0.009, respectively). In a subgroup analysis of radiated patients (neoadjuvant or adjuvant) (n =508; 464 subpectoral, 44 prepectoral), there was no difference between BREAST-Q scores of subpectoral and prepectoral patients. Patients with prepectoral devices were more likely to be affected by seromas (p=0.004) or wound dehiscence (p=0.020). CONCLUSION: Our preliminary analysis shows that, among patients undergoing alloplastic breast reconstruction, PROs are superior following prepectoral placement. However, the complication profile slightly favors subpectoral reconstruction. Additional long-term analyses should be conducted to better assess the differences between the prepectoral and subpectoral technique.

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          Author and article information

          Journal
          Plast Reconstr Surg Glob Open
          Plast Reconstr Surg Glob Open
          GOX
          Plastic and Reconstructive Surgery Global Open
          Lippincott Williams & Wilkins (Hagerstown, MD )
          2169-7574
          19 May 2023
          May 2023
          : 11
          : 5 Suppl , PSRC 2023 Meeting Abstract Supplement
          : 106-107
          Affiliations
          [1 ]Memorial Sloan Kettering Cancer Center, New York, NY, USA.
          Article
          00168
          10.1097/01.GOX.0000938264.95820.de
          10194553
          796e0b93-3162-40e6-97cc-927a7403bfab
          Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.

          This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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          PSRC 2023 Meeting Abstract Supplement
          Oral Presentations
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