Novel Pre-Mastectomy Permanent Implant Reconstruction

Background: Breast reconstruction has been shown to have significant psychosocial benefits for breast cancer patients. Multiple techniques have been used to improve patient satisfaction, aesthetic outcomes, and decrease complications. However, while these techniques are advantageous, they have some significant disadvantages. We are presenting a novel two-stage, pre-mastectomy permanent implant reconstruction (PPIR) technique in an attempt to overcome some of these disadvantages. Methods: Five patients met the essential criteria: they underwent PPIR by insertion of silicone implants three weeks before a proposed mastectomy. The Short Form-36 quality of life questionnaire and the Michigan Breast Reconstruction Outcomes Survey were used before and after the surgery to assess outcome and patient satisfaction. Paired sample t-tests were used to compare changes in the survey scores for various psychosocial subscales and to determine whether score changes after reconstruction were significant. Result: Five patients underwent seven breast reconstructions using PPIR. None of the patients experienced surgical complications (e.g. mastectomy flap complication, wound dehiscence, surgical site infection, or implant-related complications). The PPIR technique resulted in improved psychosocial outcomes and body image with high patient satisfaction. Conclusion: Pre-mastectomy permanent implant reconstruction is a promising potential technique with good aesthetic outcome and patient satisfaction that carries no tissue expander complications and eliminates multiple clinic visits and the usage of a dermal substitute.