Surgical Outcomes of Implant-based Breast Reconstruction Using TiLoop Bra Mesh Combined With Pectoralis Major Disconnection

Objective This study aimed to compare breast symmetry and patient satisfaction with breast appearance between implant-based breast reconstruction using TiLoop Bra mesh combined with pectoralis major disconnection (IMR) and conventional implant reconstruction (IR), and to analyze differences in complications. Methods This retrospective study included 59 patients administered IMR or IR in 2016 to 2018. Three-dimensional scanning was performed to objectively evaluate breast symmetry. The BREAST-Q scale was used to survey satisfaction with breast appearance, social psychosocial health, physical health, and sexual well-being. Results There were no significant differences in age, TNM stage, and chemotherapy between the 2 groups (all P > 0.05). In 3-dimensional scanning data, patients who underwent IMR had better bilateral breast symmetry compared with those administered IR (all P < 0.001). Based on the BREAST-Q survey, the satisfaction rate was significantly higher for IMR compared with IR (P = 0.0368), whereas psychosocial health, physical health, and sexual well-being showed no significant differences between the 2 groups (all P > 0.05). The IMR model showed no obvious advantages in common complications, including hematoma, incision site infection, skin flap necrosis, and prosthesis exposure and rupture compared with IR; loss of skin and nipple sensations was evident in both groups. The IMR model was associated with reduced incidence of fibrous capsule contracture compared with IR (0% vs 18.75%, P = 0.0267). The incidence rates of pectoralis major disconnection syndrome after IMR and IR were 18.50% and 0%, respectively (P = 0.0161). Conclusions Patients administered IMR have better breast symmetry and greater satisfaction with breast appearance compared with those treated by IR; however, IMR has unique complications, including pectoralis major disconnection syndrome.

目的：本研究旨在比较使用TiLoop Bra网片联合胸大肌离断的假体植入式乳房重建（IMR）与常规假体植入重建（IR）在乳房对称性以及患者对乳房外观满意度方面的情况，并分析并发症的差异。 方法：这项回顾性研究纳入了2016年至2018年接受IMR或IR的59例患者。通过三维扫描客观评估乳房对称性。采用BREAST - Q量表调查对乳房外观、社会心理健康、身体健康和性健康的满意度。 结果：两组在年龄、TNM分期和化疗方面无显著差异（均P>0.05）。在三维扫描数据中，接受IMR的患者与接受IR的患者相比，双侧乳房对称性更好（均P<0.001）。根据BREAST - Q调查，IMR的满意度显著高于IR（P = 0.0368），而两组在社会心理健康、身体健康和性健康方面无显著差异（均P>0.05）。与IR相比，IMR模型在常见并发症（包括血肿、切口部位感染、皮瓣坏死以及假体暴露和破裂）方面无明显优势；两组均存在皮肤和乳头感觉丧失。与IR相比，IMR模型纤维包膜挛缩的发生率降低（0%比18.75%，P = 0.0267）。IMR和IR后胸大肌离断综合征的发生率分别为18.50%和0%（P = 0.0161）。 结论：与接受IR治疗的患者相比，接受IMR的患者乳房对称性更好，对乳房外观的满意度更高；然而，IMR有独特的并发症，包括胸大肌离断综合征。