Abstract PS1-64: Prepectoral implant-based breast reconstruction with TiLOOP-bra pocket - a single-center retrospective study
Authors: Nguyen Bich Doan , Vorburger Denise , Frauchiger-Heuer Heike , Bringolf Lilian , Maggi Nadia , Talimi-Schnabel Julia , Dedes Konstantin 
Published: February 2021

Aim: To evaluate the perioperative outcome and cosmetic outcome of prepectoral implant-based breast reconstruction using the TiLOOP® Bra Pocket.Background: Besides acellular dermal matrix (ADM), synthetic meshes have revealed good surgical and aesthetic outcomes. We present our data using TiLOOP® Bra Pocket, a ready-to-use mesh pocket which is made out of nonresorbable, titanized, lightweight polypropylene with a monofilament structure and designed to ensure optimal fixation of the breast implant following mastectomy. The idea behind the mesh pocket is to fix the implant to the muscle and provide coverage and stabilization for the implant by serving as an ´internal bra´, which will create an inferior and lateral sling to support the position and stability of the implant and prevent it from dislocating or twisting.

Materials and Methods: A single-center retrospective study was performed to assess short-term complication rates and cosmetic outcomes in patients with immediate or delayed implant-based breast reconstruction using the TiLOOP® Bra Pocket after nipple- or skin-sparing mastectomy. The primary endpoint was complication rates, which were divided into major and minor complications during the first 6 months. Minor complications were defined as those treated conservatively, major complications were those requiring surgical therapy. The secondary endpoint was short-term cosmetic outcome after 6 to 12 months, which was judged by two professionals using the Harvard score (1 = poor, 2 = fair, 3 = good, 4 = excellent).

Results: A total of 63 breasts (43 patients) were reconstructed by implant using the TiLOOP® Bra Pocket between 2018 and 2020, of which 57 were immediate reconstructions. Mean follow-up was 12 months. The overall complication rate was 30,2 % (n = 19/63). Major complications occured in 7 breasts (n = 7/63; 11,1 %) and minor complications occured in 12 breasts (12/63; 19,0 %). The cosmetic outcome was good (Harvard score: mean 3, range 1-4; SD 0,75). Seventeen cosmetic complications were observed (17/63; 27,0 %) and 6 cosmetic revision surgeries were performed (6/63; 9,5 %).

Conclusion: Immediate prepectoral implant-based breast reconstruction with the TiLOOP® Bra Pocket seems to be a feasible method with moderate complication rates and good cosmetic outcomes. Careful patient selection and preparation techniques considering flap viability are vital in order to achieve acceptable complication rates and satisfying cosmetic results. Long-term follow-up is needed. The next follow-up will be performed after 24 months.

Perioperative OutcomeComplications22Seroma with punction7/63 (11,1%)Seroma without punction1/63 (1,6 %)Hemorrhage2/63 (3,2 %)Nipple necrosis2/63 (3,2 %)Implant Infection3/63 (4,8 %)Skin Infection3/63 (4,8 %)Wound healing deficiency2/63 (3,2 %)Implant loss2/63 (3,2 %)Unplanned resurgery &lt; 3 mo8 (12,7 %)

Cosmetic Complication (N=17)Rippling2 (3,2 %)Asymmetry4 (6,3 %)Capsule contracture3 (4,8 %)Fat defects3 (4,8 %)Rotation2 (3,2 %)Cranialisation3 (4,8 %)

Cosmetic Outcome (Harvard score; 1 = poor, 2 = fair, 3 = good, 4 = excellent)Observer 13,0 (1 - 4), SD 0,8Observer 23,4 (1-4), SD 0,7

Citation Format: Bich Doan Nguyen, Denise Vorburger, Heike Frauchiger-Heuer, Lilian Bringolf, Nadia Maggi, Julia Talimi-Schnabel, Konstantin Dedes. Prepectoral implant-based breast reconstruction with TiLOOP-bra pocket - a single-center retrospective study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-64.