PC28. SURGICAL AND PATIENT-REPORTED OUTCOMES OF 694 TWO-STAGE PREPECTORAL VS. SUBPECTORAL BREAST RECONSTRUCTIONS

Abstract

PURPOSE: The purpose of this study is to assess the differences in complication rates and patient satisfaction between patients who underwent prepectoral and subpectoral implant-based breast reconstruction (IBR). METHODS: We conducted a retrospective cohort study of patients who underwent two-stage IBR at our institution in 2018-2019. The study cohort was divided into those who received prepectoral and subpectoral tissue expander (TE). Surgical and patient-reported outcomes were compared between the groups. RESULTS: A total of 694 reconstructions in 481 patients were identified (77% prepectoral, 17% subpectoral). The mean BMI was higher in the prepectoral group (27 vs. 25 kg/m2, p=0.001) while age and other comorbidities were similar between the two study cohorts. Patients in the prepectoral group were less likely to undergo postoperative radiotherapy (p=0.001). The overall complication rate was very similar at 29.3% in the prepectoral and 28.9% in the subpectoral group (p=0.887). Individual complications were also similar between the two groups. Device explantation occurred in 11.3% vs. 14% (p=0.436) of prepectoral vs. subpectoral IBRs, respectively. On multiple frailty model, device location was not associated with overall complications, infection, major complications, or device explantation. Mean satisfaction with the breast, psychosocial well-being, and sexual well-being were similar between the two groups. Median time to permanent implant exchange was significantly longer in the subpectoral group (200 vs. 150 days, p<0.001). CONCLUSION: Prepectoral breast reconstruction results in similar surgical outcomes and patient satisfaction compared to patients undergoing subpectoral IBR.