RESUMEN
BACKGROUND: Conversion of subpectoral reconstruction to the prepectoral plane has been increasing in popularity. However, there is a paucity of research assessing patient-reported outcomes following this operation. The primary aim of this study is to examine patient-reported outcomes following conversion of implants from the subpectoral to prepectoral plane through utilization of the BREAST-Q. METHODS: We retrospectively examined patients who underwent subpectoral to prepectoral implant conversion by three surgeons at two separate centers from 2017-2021. Patient demographics, primary indication for the conversion, surgical characteristics, postoperative outcomes, and BREAST-Qs were obtained. RESULTS: Sixty-eight breasts in 39 patients underwent implant conversion. The most common primary indications for implant conversion were chronic pain (41%), animation deformity (30%), and cosmetic concerns (27%). Average BREAST-Q scores improved significantly preoperatively to postoperatively in all the domains measured ("satisfaction with breasts", "satisfaction with implants", "physical well-being," "psychosocial well-being," and "sexual well-being") (p<0.01). When examined by primary indication, all cohorts had significant preoperative to postoperative score improvement in "satisfaction with breasts" (p<0.001) and "physical well-being" (p<0.01) domains. Fifteen breasts (22%) developed postoperative complications, with implant loss in 9% of breasts. CONCLUSIONS: :Conversion of subpectoral implants to the prepectoral plane significantly improves BREAST-Q outcomes in all aspects, including patient satisfaction with breasts and implants, as well as psychosocial, physical, and sexual well-being. Implant conversion to the prepectoral plane in now becoming our primary solution to most patients with chronic pain, animation deformity or cosmetic concerns after subpectoral reconstruction.
RESUMEN
There are significant differences in weight and volumetric characteristics between silicone and saline breast implants of which most plastic surgeons are unaware. Phase I of this study was a weight measurement focused on recording differences in the weight of saline volumes instilled versus recorded weights of saline implants and expanders. Phase II compared displaced volume differences of tissue expanders with instilled volumes. As a result of this study, surgeons should now be able to precisely calculate the volume created for breast pocket development, allowing for accurate matching of expander and final breast implant.