The relationship of human acellular dermal matrix thickness on complication rate and patient-reported outcomes in implant-based immediate breast reconstruction

Background: As it can be said that prosthetic breast reconstruction has been increased by the use of acellular dermal matrices (ADMs), ADMs are widely used in implant reconstruction. A large variety types of ADMs are now produced, but there is a paucity of data comparing the ADM products directly. We evaluated the effects of ADM thickness on complication rates and patient satisfaction after dual-plane subpectoral ADM-assisted implant breast reconstruction. Methods: A retrospective study of patients who underwent immediate implant breast reconstruction using ADM was performed. We compared clinical course and postoperative outcomes for two ADM groups with different thicknesses [thin ADMs, 0.6-1.5 mm (group 1) vs. thick ADMs, 1.5-3.0 mm (group 2)] based on the incidence of complications and the duration of drainage. Patient satisfaction was also evaluated using the Breast Questionnaire (BREAST-Q), 6 months after surgery. Results: A total of 51 patients were included in the study (group 1, n=21; group 2, n=30). Patient demographics were similar between the two groups, and no difference in postoperative complication rate (P>0.05) and Jackson-Pratt (JP) drainage durations (P>0.05). On regression analysis, ADM thickness was not an independent factor for any complication subtype. There were also no significant differences in BREAST-Q results, across all metrics, between the study groups. Conclusions: In dual plane subpectoral implant placement breast reconstruction with an inferior ADM-sling, the thickness of ADM was not a factor in determining postoperative complications and patient satisfaction. Therefore, it is possible to select the thickness according to the surgeon's preference.