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Implant-Based Breast Reconstruction

Hot Topics, Controversies, and New Directions

Frey, Jordan D., M.D.; Salibian, Ara A., M.D.; Karp, Nolan S., M.D.; Choi, Mihye, M.D.

Plastic and Reconstructive Surgery: February 2019 - Volume 143 - Issue 2 - p 404e–416e
doi: 10.1097/PRS.0000000000005290
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Learning Objectives: After studying this article, the participant should be able to: 1. Evaluate appropriate patients best suited for one- or two-stage alloplastic breast reconstruction. 2. Discuss and apply the unique advantages and disadvantages of scaffold use and different implant types in breast reconstruction to maximize outcomes. 3. Develop a plan for patients undergoing implant-based breast reconstruction requiring postmastectomy radiation therapy. 4. Analyze the evidence with regard to antibiotic prophylaxis in implant-based breast reconstruction. 5. Recognize and critique novel technical and device developments in the field of alloplastic breast reconstruction, enabling appropriate patient selection.

Summary: Implant-based, or alloplastic, breast reconstruction is the most common method of breast reconstruction in the United States. Within implant-based reconstruction, many techniques and reconstructive strategies exist that must be tailored for each individual patient to yield a successful reconstruction. Not unexpectedly, many hot topics and controversies in this field have emerged, including stages of reconstruction, use of scaffolds, permanent implant type, strategies for postmastectomy radiation therapy, and antibiotic prophylaxis. In addition, there has been an evolution in technical and device development in recent years. Therefore, plastic surgeons must be on the forefront of knowledge to approach implant-based breast reconstruction in an evidence-based fashion to best treat their patients.

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New York, N.Y.

From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.

Received for publication June 21, 2018; accepted September 19, 2018.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Mihye Choi, M.D., New York University Langone Health, 305 East 47th Street, Suite 1A, New York, N.Y. 10017,, Twitter: @JordanFreyMD, @AraSalibianMD, @MihyeChoi, @NolanKarp, Instagram: @jordanfreymd, @arasalibianmd, @choim01, @nolankarp, Facebook: Jordan Frey, Ara Salibian, Mihye Choi, Nolan Karp

©2019American Society of Plastic Surgeons