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Mesh-pocket supported prepectoral implant-based breast reconstruction: Final results of a retrospective analysis
Paepke S.1, Kiechle M.1, Ankel C.2, Ohlinger R.3, Thill M.4, Kelling K.4, Baumann K.5, Pursche T.6, Strittmatter H.-J.7, Bangemann N.8, Blohmer J.-U.9, Weyrich J.1, Steffek A.10, Sawatzki M.11, Fysh T.12, Bensmann E.13, Dedes K.14, Rezai M.15, Hilmer K.16, Bräuer M.17, Dupont D.18, Huelbes Ros A.19, Critchley A.20, Lüdders D.21, Singh V.22, Kunjuraman B.23, Mett R.24, Hadad S.25, Findt S.26, Shtian A.27, Aydogdu M.28, Ollig S.29, Faridi A.30
1Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Frauenheilkunde, München, Deutschland, 2Rotkreuzklinikum München, Gynäkoloigsches Krebszentrum, München, Deutschland, 3Universitätsmedizin Greifswald, Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde, Greifswald, Deutschland, 4AGAPLESION MARKUS KRANKENHAUS, Gynäkologisches Krebszentrum, Frankfurt am Main, Deutschland, 5UKSH Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Deutschland, 6Krankenhaus Düren, Brustzentrum, Düren, Deutschland, 7Rems-Murr-Klinikum Winnenden, Winnenden, Deutschland, 8Carl-Thiem-Klinikum Poliklinik GmbH, Gynäkologie und Geburtshilfe, Cottbus, Deutschland, 9Campus Charité Mitte (CCM), Klinik für Gynäkologie mit Brustzentrum, Berlin, Deutschland, 10Johanniter Krankenhaus Stendal, Stendal, Deutschland, 11Helios Klinikum Bad Saarow, Klinik für Senologie, Bad Saarow, Deutschland, 12Medical Specialist Group LLP, Guernsey, Vereinigtes Königreich, 13Evangelisches Krankenhaus Bethesda Mönchengladbach, Mönchengladbach, Deutschland, 14Universitätsspital Zürich, Zürich, Schweiz, 15Luisenkrankenhaus Düsseldorf, Europäisches Brustzentrum, Düsseldorf, Deutschland, 16Helios Klinikum, Girfhorn, Deutschland, 17Gemeinschaftskrankenhaus Herdecke, Herdecke, Deutschland, 18Klinikum Lippe Lemgo, Lemgo, Deutschland, 19Hospital Reina Sofía Murcia, Madrid, Spanien, 20Tyne Hospitals Newcastle, Newcastle, Vereinigtes Königreich, 21Klinikum Oldenburg, Oldenburg, Deutschland, 22Armadale Health Service Perth, Perth, Australien, 23Royal Perth Hospital Perth, Perth, Australien, 24Helios Klinik Schwerin, Schwerin, Deutschland, 25Royal Hallamshire Hospital Sheffield, Sheffield, Vereinigtes Königreich, 26Evangelisches Krankenhaus Wesel, Wesel, Deutschland, 27Karolinen Hospital Arnsberg, Arnsberg, Deutschland, 28Klinikum Bremen-Mitte Bremen, Bremen, Deutschland, 29Diakonissenkrankenhaus Dresden, Dresden, Deutschland, 30Universitätsklinikum Bonn, Bonn, Deutschland

Zielsetzung: Implant based breast reconstruction gained a high and increasing level of importance during the past years, currently performed with placement of the implant in a pre-pectoral pocket. Although safety and breast aesthetics of this approach are well recognized prepectoral techniques adds a whole new dimension with the development of the next generation of specific for prepectoral implant placement created titanized implant pockets - especially in patients with smooth implants.
Material und Methoden: A retrospective net-based documentation was done from the introduction of the Tiloop®Bra-Pocket in 10/2017 in 135 patients (42 patients with bilateral procedures).
Ergebnisse: From on 10/2017 until 09/2018 mesh-pocket supported breast reconstructions were analysed. Age of the patients was between 23 and 81 years. The mean BMI was 24.7 ± 4.6 kg/m2. Cosmetic outcome, was rated in 85.9% as very satisfied, in 11.9% as somewhat satisfied and in 0.7% as somewhat dissatisfied. Handling and feasibility of this new product and the prepectoral implant position was easy and sufficient in all cases.
Zusammenfassung: Use of TilOOP®Bra-Pocket enables a new standard of prepectoral reconstructive techniques preserves the natural anatomy, thereby avoiding adverse effects associated with submuscular reconstruction, minimizing postoperative pain, risk of bleeding and the lack of animation deformity like “jumping breast phenomen”. Pocket-supported reconstructive techniques become more valuable in times of changing to implants with smooth surface due to the excellent stabilization of implant position. Since 7/2019 a prospective international multicenter trial is ongoing to demonstrate patient reported outcome parameters (PRO TiLOOP®-Pocket-Trial CLINICALTRIALS.GOV NCT03868514 and DRKS00016673).