One-stage immediate implant-based breast reconstruction,using biological matrices after conservative mastectomies:preliminary experience of the University Hospital of Tor Vergata

Aim. Aim of our study was to achieve one-stage immediate implant based breast reconstruction, using biological matrices after conservative mastectomies, evaluate patients outcome and complications, in patients suffering from stage Tis-T1-T2 (<3 cm) breast cancer who underwent conservative mastectomy and reconstructive surgery. Methods. The inclusion criteria were: aged 20-65 years; nonsmokers; no diabetes or systemic connective disease; BMI<30; Patients should not be subjected to post-mastectomy radiotherapy; informed consent. During our study, through a randomization system, we used two different types of acellular dermal matrices (ADM): SurgiMend® and Tutomesh®. Results. From February 2012 to March 2014, 22 patients were enrolled, for a total of 38 reconstructions (average age 49 years). Ten patients did not have any mesh-related complications. Four patients showed a dehiscence with bilateral implant exposure, which required removal of the implants; minor wound dehiscence (healing within a month) was observed in 4 patients; 2 patients presented an asymmetry of the inframammary folds and a hematoma was found in two patients. Conclusion. The introduction of the ADM has helped to overcome several reconstructive limitations, allowing an immediate prosthetic reconstruction, after a conservative mastectomy. Complications have been drastically reduced due to an accurate selection of patients. In conclusion, one-stage breast reconstruction with acellular biological matrices, in selected patients, may be a new and realistic frontier in breast surgery, with the real possibility of providing women with breast cancer, a better quality of life compared to the traditional two-stage reconstruction.