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An Initial Experience and Usefulness of Porcine Acellular Dermal Matrix (PADM) Assisted Prepectoral Breast Implant Surgery: Case Series and Systematic Review


 Background: We report our experience with performing prepectoral placement breast implant surgery using Supporix TM (HansBiomed, Korea), a porcine acellular dermal matrix (PADM), for cosmetic and reconstructive indications. The clinical efficiency, safety, and cost-effectiveness of PADM were also discussed. Methods: A single-center, retrospective study was designed from December 2017 to December 2019. The participants were Korean female patients who had PADM-assisted prepectoral breast implant surgery performed by two surgeons (S.G.K. & H.B.S.). All complications were registered and analyzed. A systematic review and meta-analysis of the complication rates after PADM-assisted prepectoral breast implant surgery were conducted for comparison with other studies. Subgroup analysis was performed in three groups according to the operation type: the cosmetic breast surgery (CBS) group, the immediate implant-based breast reconstruction (IIBR) group, and the delayed implant-based breast reconstruction (DIBR) group. Results: A total of 20 breasts in 16 patients were included in our study with a median follow-up period of 8.25 months. In a systematic review, 20 publications with a total of 2,504 breasts in 1,921 females were quantitively analyzed. The overall complication rates in our study and other studies were 14% and 24% in total group analysis, 0% and 12% in the CBS group, 62% and 26% in the IIBR group, and 0% and 28% in the DIBR group, respectively.Conclusion: Our data support the effectiveness of PADM-assisted prepectoral breast implant surgery, which was comparable to other studies. PADM was effective for reducing seroma and hematoma in the revision CBS group and the DIBR group. In the IIBR group, it was helpful in preventing implant loss and explantation.