Immediate one-stage subcutaneous breast reconstruction without ADM: A single-center 6-year experience

Prepectoral breast reconstruction without acellular dermal matrix (ADM) is gaining attention as a potentially safe and effective approach, particularly in non-irradiated patients. This study aimed to evaluate the safety and efficacy of immediate one-stage prepectoral breast reconstruction without ADM and assess the impact of radiation therapy (RT) on postoperative outcomes. A retrospective review of 198 patients (239 breasts) who underwent mastectomy followed by direct-to-implant prepectoral reconstruction without ADM between 2018 and 2023 was performed. Patients were divided into RT and non-RT groups. Demographics, complications, and secondary procedures were analyzed. Fisher's exact tests were used for statistical correlation. In the non-RT group, complication rates were low, with capsular contracture observed in 6 patients (3.5%). In the RT group, capsular contracture was significantly higher (p < 0.0001). Other complications were comparable between groups. Secondary procedures were more frequent in the RT group. Immediate prepectoral breast reconstruction without ADM is a safe and effective option, especially in non-irradiated patients, with acceptable complication rates and favorable surgical outcomes.